Jeanne Boudreaux, MD

Primary specialty

Hematology & Oncology PhysicianTaxonomy code 207RH0003X

License

43559 Issued in GA

Practice address

5461 Meridian Mark Rd Ste 400
Atlanta, GA 30342-3283

Phone

(404) 785-1112

Fax

(404) 785-3600

NPI assigned

Jun 20, 2006

Last updated

Jun 6, 2022By 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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in GA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jboudreaux3106@choa.gadirect.net

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.

• Specialty Providers at Children's, LLC

  • Pediatric Dentistry
  • Brookhaven, GA
  • NPI 1346606076
  NPD
• Arthur M. Blank Hospital, Inc.

  • Children's Hospital
  • Atlanta, GA
  • NPI 1689744450
  NPD (past)
• Choa Hospital Based, LLC

  • Pediatrics Physician
  • Brookhaven, GA
  • NPI 1457695488
  NPD (past)
• Egleston Children's Hospital at Emory University, Inc.

  • Pediatric Emergency Medicine (Pediatrics) Physician
  • Atlanta, GA
  • NPI 1558416701
  NPD (past)
• Scottish Rite Children's Medical Center

  dba Children's Healthcare of Atlanta at Scottish Rite

  • Pediatric Hematology & Oncology Physician
  • Atlanta, GA
  • NPI 1184779332
  NPD (past)

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

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654473600000",
    "number": "1093751190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5461 MERIDIAN MARK RD STE 400",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303423283",
            "telephone_number": "404-785-1112",
            "fax_number": "404-785-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5461 MERIDIAN MARK RD STE 400",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303423283",
            "telephone_number": "404-785-1112",
            "fax_number": "404-785-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUDREAUX",
        "first_name": "JEANNE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-20",
        "last_updated": "2022-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "GA",
            "license": "43559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "choa@choa.gadirect.net",
            "affiliation": "N",
            "address_1": "5461 Meridian Mark Rd Ste 400",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303423283",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Megan Boucher, BCBA
• Yazan Adam Bouchi
• Ghizlane Bouchrit, MD
• Megan Alyssa Boudouin, PHARMD
• Elise Boudreaux, CAA
• Sara Boufakhreddine, RN
• Elizabeth Bouffanie
• Leah Bougere, PSY.D.
• Joyce A Bouknight Gant, REGISTERED NURSE
• Emerson Bouldin

• Hematology & Oncology Physician in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Hematology & Oncology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.