Active NPI
Joseph Todd Boudreau, D.C.
- Chiropractor
- Lanoka Harbor, NJ
National Provider Identifier
1083770671
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 38MC00657100
- Practice address
- 411 US Highway 9
Suite 1
Lanoka Harbor, NJ 08734-2818 - Phone
- (609) 971-0101
- Fax
- (609) 971-0109
- NPI assigned
- Dec 28, 2006
- Last updated
- Oct 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CH 7984 | FL | |
| Chiropractor | 111N00000X | 38MC00657100 | NJ | Primary |
Addresses
Primary practice location
411 US Highway 9
Suite 1
Lanoka Harbor, NJ 08734-2818
Mailing address
411 US Highway 9
Suite 1
Lanoka Harbor, NJ 08734-2818
Phone (609) 971-0101
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 111509WL9 | Other | NJ | RENERING PROVIDER NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CH 7984 | FL | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| James McErlain DC PA | Chiropractor | Past | Accepting new patients |
| Jupiter Healthcare | Chiropractor | Past | Accepting new patients |
| Boudreau Chiropractic Center Inc | Chiropractor | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Chiropractor
- Lanoka Harbor, NJ
- NPI 1861613192
-
- Chiropractor
- Jupiter, FL
- NPI 1750447397
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167264000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1191801600000",
"number": "1083770671",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "411 US HIGHWAY 9",
"address_2": "SUITE 1",
"city": "LANOKA HARBOR",
"state": "NJ",
"postal_code": "087342818",
"telephone_number": "609-971-0101",
"fax_number": "609-971-0109"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "411 US HIGHWAY 9",
"address_2": "SUITE 1",
"city": "LANOKA HARBOR",
"state": "NJ",
"postal_code": "087342818",
"telephone_number": "609-971-0101",
"fax_number": "609-971-0109"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOUDREAU",
"first_name": "JOSEPH",
"middle_name": "TODD",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-28",
"last_updated": "2007-10-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "FL",
"license": "CH 7984",
"primary": false
},
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NJ",
"license": "38MC00657100",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RENERING PROVIDER NUMBER",
"identifier": "111509WL9",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lanoka Harbor, NJ
- Ars Treatment Centers of New Jersey, PC (Crossroads Treatment Centers)
- Association for the Multiple Impaired Blind, Inc. (Amib)
- Avelina Flores, M.D.P.C.
- Katherine L Borchert
- Boudreau Chiropractic Center Inc
- Brett Novick, LMFT
- Kathleen Elizabeth Britton, PHARMACIST
- Terry K Brooks, NP-C
- Building Blocks Behavior Therapy
- Bridget V Burns
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.