Philip C Boulanger, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

0101057867 Issued in VA

Practice address

5911 W Broad St
Richmond, VA 23230-2219

Phone

(804) 213-0259

NPI assigned

Jan 27, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

General Practice

Education

University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Central Virginias Preferred ProvidersGroup PAC ID 1557793528, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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

• Central Virginias Preferred Providers

  • Mental Health Counselor
  • Richmond, VA
  • NPI 1730638107

  VA

  Medicare reassignment Care Compare group NPD
• Advanced Health Inc

  • Clinical Medical Laboratory
  • Winchester, VA
  • NPI 1174529754
  NPD (past)
• Chapman Senior Care, Inc.

  • Clinical Social Worker
  • Richmond, VA
  • NPI 1669439691
  NPD (past)
• Harrisonburg Cytology Services, Inc.

  • Clinical Medical Laboratory
  • Harrisonburg, VA
  • NPI 1669402947
  NPD (past)
• Hype Counseling Services LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Richmond, VA
  • NPI 1457821001
  NPD (past)
• Womens & Childrens Center LLC

  • Obstetrics & Gynecology Physician
  • Low Moor, VA
  • NPI 1831380260
  NPD (past)

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

{
    "created_epoch": "1138320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680652800000",
    "number": "1083685366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1891 VIRGINIA AVE",
            "city": "HARRISONBURG",
            "state": "VA",
            "postal_code": "228028374",
            "telephone_number": "804-389-2606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5911 W BROAD ST",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232302219",
            "telephone_number": "804-213-0259"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5236 Timber Hollow Pl",
            "address_purpose": "LOCATION",
            "city": "Glen Allen",
            "state": "VA",
            "postal_code": "230602846",
            "country_code": "US",
            "telephone_number": "804-389-2606",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1891 Virginia Ave",
            "address_purpose": "LOCATION",
            "city": "Harrisonburg",
            "state": "VA",
            "postal_code": "228028374",
            "country_code": "US",
            "telephone_number": "804-389-2606",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOULANGER",
        "first_name": "PHILIP",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-27",
        "last_updated": "2023-04-05",
        "certification_date": "2023-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101057867",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101057867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Elizabeth Bouchard, M.D.
• Maryann Boucher, PSYD
• Aubrey Bouchoux
• Sylvia Hannah Boudali, CNM
• Doumit S. Bouhaidar, M.D.
• Ashley Bouldin
• Camryn Bouldin, RBT
• Boundless Potential, LLC
• Iliana Simeonova Bouneva, MD
• Coffee Bourne, CRNA

• All providers in Richmond, VA
• Internal Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2023; 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.