Leslie Jean Boucherle, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-08357 Issued in NC

Practice address

4740 Commercial Park CT
Clemmons, NC 27012-9387

Phone

(336) 245-9521

Fax

(855) 308-2340

NPI assigned

Sep 10, 2018

Last updated

Apr 14, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lamond Family Medicine PLLCGroup PAC ID 6103802012, 49 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lamond Family Medicine, PLLC

  dba Blue Sky MD

  • Family Medicine Physician
  • Hendersonville, NC
  • NPI 1629037270
  Medicare reassignment Care Compare group

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1536537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744588800000",
    "number": "1043793789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 360",
            "city": "SYLVA",
            "state": "NC",
            "postal_code": "287790360",
            "telephone_number": "888-339-6065",
            "fax_number": "828-538-4441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4740 COMMERCIAL PARK CT",
            "city": "CLEMMONS",
            "state": "NC",
            "postal_code": "270129387",
            "telephone_number": "336-245-9521",
            "fax_number": "855-308-2340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUCHERLE",
        "first_name": "LESLIE",
        "middle_name": "JEAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-10",
        "last_updated": "2025-04-14",
        "certification_date": "2025-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-08357",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARESOURCE",
            "identifier": "CS2404500385",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1043793789",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "NN4763B",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NC",
            "identifier": "200R1",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "Q00092493",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carl David Bollinger, O.D.
• Aubrey Gayle Boos
• Holly Antony Borders, M.D.
• Jessica Diane Born, FNP
• Margo Born, CD,DONA
• Marianna Bowen, LCMHC
• Catherine R Bradford, ARNP
• Sukhdev Singh Brar, DO
• Madeline Gautreaux Brence, PHYSICIAN ASSISTANT
• Rachel Hannah Bretz

• Physician Assistant in Clemmons, NC
• Providers in Clemmons, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.