John Boileau, FNP-C
Individual provider Active NPI Nurse Practitioner · Gallatin, TN
NPI 1104309665 · NPPES record last updated Sep 11, 2018
Key facts
- NPI
- 1104309665
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 24724 (TN)
- Practice address
- 355 Woodlands Dr
Gallatin, TN 37066-4730 - Phone
- (615) 451-1580
- NPI assigned
- Sep 11, 2018
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220816001077 | TN | Practitioner - Nurse Practitioner | 2163805623 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Saint Thomas Medical Partners | Current |
Accepting new patients | |
| Saint Thomas Hickman Hospital | Current | Accepting new patients | |
| Hickman Community Health Careservices | Current |
Accepting new patients | |
| Saint Thomas Hickman Hospital | Current |
Accepting new patients |
Locations
150 E Swan St
Centerville, TN 37033
Phone (931) 729-3091
300 20th Ave N
Ste 403
Nashville, TN 37203
Phone (615) 284-4088
435 Sewell Dr
Sparta, TN 38583
Phone (931) 738-4595
Interoperability endpoints
- john.boileau.3@7654.direct.athenahealth.com
- john.boileau.2@7654.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 24724 | TN | Yes |
Addresses
Primary practice location
355 Woodlands Dr
Gallatin, TN 37066-4730
Mailing address
355 Woodlands Dr
Gallatin, TN 37066-4730
Phone (615) 451-1580
Other providers in Gallatin, TN
- Nikolas Blascoe
- Holly Block
- Bloom Speech & Language Therapy, PLLC
- Jamie M Boggs
- Cassie Bogle
- Paul Allen Bolling
- Allison Bonds
- Kelly Bornefeld
- Jacob Bourget
- Andrea Jeanne Noelani Boyd
All providers in Gallatin, TN · Nurse Practitioner in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 11, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.