Lyette Boucher, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH11313 Issued in FL

Practice address

5644 Tavilla Cir Ste 104
Naples, FL 34110-3404

Phone

(239) 325-8226

Fax

(239) 325-8226

NPI assigned

Mar 18, 2013

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

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 and National Provider Directory roles.

• Kin Med, PA

  • General Practice Physician
  • Estero, FL
  • NPI 1861994204
  NPD (past) Authorized official

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

{
    "created_epoch": "1363564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1104168194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5644 TAVILLA CIR STE 104",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341103404",
            "telephone_number": "239-325-8226",
            "fax_number": "239-325-8226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5644 TAVILLA CIR STE 104",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341103404",
            "telephone_number": "239-325-8226",
            "fax_number": "239-325-8226"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10971 Bonita Beach Rd SE",
            "address_2": "suite 3",
            "address_purpose": "LOCATION",
            "city": "Bonita Springs",
            "state": "FL",
            "postal_code": "341359028",
            "country_code": "US",
            "telephone_number": "239-221-7123",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "19910 S Tamiami Trl Ste C",
            "address_purpose": "LOCATION",
            "city": "Estero",
            "state": "FL",
            "postal_code": "339284140",
            "country_code": "US",
            "telephone_number": "239-948-1222",
            "fax_number": "239-948-1220",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOUCHER",
        "first_name": "LYETTE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-18",
        "last_updated": "2022-07-21",
        "certification_date": "2020-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.012357",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH11313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carlan Bostick, PA-C
• Erin Ann Bostick
• Monique Suezette Botana, MS, CCC-SLP
• Patricia Elizabeth Botero, DMD
• Francis C Boucek, M.D.
• Yesnicey Bouquet Pena
• Denis Bousquet, R.PH.
• Alexandra Alekseevna Bovbel, M.D.
• Nancy Bove
• Gayla Bowden, MSW

• Chiropractor in Naples, FL
• Providers in Naples, FL by specialty
• Chiropractor in Florida

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.