Richard C Boughn, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD10079 Issued in OR

Practice address

613 N 1St Ave
Stayton, OR 97383-1704

Phone

(503) 769-7771

Fax

(503) 769-4630

NPI assigned

Dec 13, 2006

Last updated

Jun 12, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Richard C. Boughn, MD PC

  • Family Medicine Physician
  • Stayton, OR
  • NPI 1699086074
  Authorized official Same address or phone

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591920000000",
    "number": "1114088101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "613 N 1ST AVE",
            "city": "STAYTON",
            "state": "OR",
            "postal_code": "973831704",
            "telephone_number": "503-769-7771",
            "fax_number": "503-769-4630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "613 N 1ST AVE",
            "city": "STAYTON",
            "state": "OR",
            "postal_code": "973831704",
            "telephone_number": "503-769-7771",
            "fax_number": "503-769-4630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUGHN",
        "first_name": "RICHARD",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2020-06-12",
        "certification_date": "2020-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD10079",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "072678",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1114088101",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "OfficeAlly.com",
            "affiliation": "N",
            "endpointDescription": "EHR System",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "613 N 1st Ave",
            "city": "Stayton",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973831704",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Aron Beugli, PHARMD
• Bishop Stayton Lessee LLC (Elmcroft of Stayton)
• Jessica Bliss
• Lawrence Boone, CSA
• Anissa Bosch, CHW
• Kristen Bowman, RD
• Katelynne Marie Braff, CST, CSFA
• Eric Steven Braman, DPT
• Daniel Kelly Brinlee, CSFA, CST
• Kyle Evan Brinlee, CST

• Family Medicine Physician in Stayton, OR
• Providers in Stayton, OR by specialty
• Family Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2020; 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.