Owmy Bouloute, DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

0103301212 Issued in VA

Practice address

5049 Anchorstone Dr
Woodbridge, VA 22192-8320

Phone

(678) 517-4214

NPI assigned

Mar 3, 2011

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA, DC2 enrollments

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 2

Specialty

Podiatry

Education

New York College of Podiatric Medicine, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Bouloute Healthcare Services, LLC

  • Podiatrist
  • Woodbridge, VA
  • NPI 1104343532
  Medicare reassignment Authorized official
• Redwood Private Care, LLC

  • Home Health Agency
  • Atlanta, GA
  • NPI 1518544832
  NPD Authorized official
• Medical Specialists of New Orleans

  • Internal Medicine Physician
  • New Orleans, LA
  • NPI 1730267915
  NPD (past)

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

{
    "created_epoch": "1299110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1093013880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8653 16TH ST UNIT 7186",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209077909",
            "telephone_number": "678-517-4214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5049 ANCHORSTONE DR",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221928320",
            "telephone_number": "678-517-4214"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5801 Walnut Creek Rd",
            "address_2": "Apartment B210",
            "address_purpose": "LOCATION",
            "city": "River Ridge",
            "state": "LA",
            "postal_code": "701235600",
            "country_code": "US",
            "telephone_number": "347-359-4485",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOULOUTE",
        "first_name": "OWMY",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-03",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "VA",
            "license": "0103301212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Howard Borash, LPC
• Michel Bornacelly Perez, M.D.
• Erika Patricia Borrayo, PHD
• James Robert Boudreau, DMD
• Bouloute Healthcare Services, LLC
• Farishta Boura, MD
• Mariya Bourget, M.D.
• Sam Bowmer, M.S.W. , L.C.S.W.
• Michelle Lynn Boyd
• Carolyn R Boyer, OTR/L

• Podiatrist in Woodbridge, VA
• Providers in Woodbridge, VA by specialty
• Podiatrist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.