Individual provider Active NPI

Jeffrey W Bouley, FNP-C

  • Family Nurse Practitioner
  • Wakefield, RI
National Provider Identifier
1104440965
Registry record updated Jun 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN02341 Issued in RI
Practice address
1 River St
Wakefield, RI 02879-3214
Phone
(401) 783-0523
Fax
(401) 783-9448
NPI assigned
Jun 7, 2020
Last updated
Jun 20, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN02341 RI Primary

Addresses

Primary practice location

1 River St
Wakefield, RI 02879-3214

Mailing address

1 River St
Wakefield, RI 02879-3214
Phone (401) 783-0523

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200827001104 RI Practitioner - Nurse Practitioner 7911324595 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Thundermist Health CenterGroup PAC ID 1557270477, 161 clinicians

Practice addresses (Care Compare)

1 River St
Wakefield, RI 02879-3214
Phone (401) 783-0523

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Thundermist Health Center CurrentSince Jun 1, 2020 Accepting new patients
Thundermist Health Center CurrentSince Jun 1, 2020 Accepting new patients
Thundermist Health Center Past Accepting new patients

Locations

360 Kingstown Rd
Unit 101
Narragansett, RI 02882
Phone (401) 783-3334

1 River St
Wakefield, RI 02879
Phone (401) 783-0523

25 John a Cummings Way
Ste 302
Woonsocket, RI 02895

450 Clinton St
Woonsocket, RI 02895

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DCBEAA

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1591488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750377600000",
    "number": "1104440965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 RIVER ST",
            "city": "WAKEFIELD",
            "state": "RI",
            "postal_code": "028793214",
            "telephone_number": "401-783-0523",
            "fax_number": "401-783-9448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 RIVER ST",
            "city": "WAKEFIELD",
            "state": "RI",
            "postal_code": "028793214",
            "telephone_number": "401-783-0523",
            "fax_number": "401-783-9448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOULEY",
        "first_name": "JEFFREY",
        "middle_name": "W",
        "name_prefix": "Mr.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-07",
        "last_updated": "2025-06-20",
        "certification_date": "2025-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "RI",
            "license": "APRN02341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wakefield, RI

Sources for this page

Verify at the official NPI Registry.