Jeffrey W Bouley, FNP-C
Individual provider Active NPI Family Nurse Practitioner · Wakefield, RI
NPI 1104440965 · NPPES record last updated Jun 20, 2025
Key facts
- NPI
- 1104440965
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- APRN02341 (RI)
- Practice address
- 1 River St
Wakefield, RI 02879-3214 - Phone
- (401) 783-0523
- Fax
- (401) 783-9448
- NPI assigned
- Jun 7, 2020
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Thundermist Health Center
Practice addresses (Care Compare)
1 River St
Wakefield, RI 02879-3214
Phone (401) 783-0523
Hospital & facility affiliations
- The Miriam Hospital
- South County Hospital Inc
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in RI
- 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 |
|---|---|---|---|---|
| I20200827001104 | RI | Practitioner - Nurse Practitioner | 7911324595 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APRN02341 | RI | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thundermist Health Center | Current |
Accepting new patients | |
| Thundermist Health Center | Current |
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
450 Clinton St
Woonsocket, RI 02895
25 John a Cummings Way
Ste 302
Woonsocket, RI 02895
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/DCBEAA
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | APRN02341 | RI | Yes |
Addresses
Primary practice location
1 River St
Wakefield, RI 02879-3214
Mailing address
1 River St
Wakefield, RI 02879-3214
Phone (401) 783-0523
Other providers in Wakefield, RI
- Stacey L Bodziony
- Ryan David Boehm
- Christine Boie
- Carol Bongiovanni
- Mandy Boragine
- Michael Patrick Bradley
- Andrea Brandon
- Neil Brandon
- Breathe Kids Fitness, LLC
- George Frank Brinius
All providers in Wakefield, RI · Family Nurse Practitioner in Rhode Island
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 20, 2025. 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).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.