Active NPI
Chris George Boukedes, MD
- Anesthesiology Physician
- Greenville, SC
National Provider Identifier
1114966165
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 10901
- Practice address
- 67 Creekside Park CT
Greenville, SC 29615-4810 - Phone
- (864) 242-4602
- Fax
- (864) 242-0129
- NPI assigned
- Jun 5, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 10901 | SC | Primary |
Addresses
Primary practice location
67 Creekside Park CT
Greenville, SC 29615-4810
Mailing address
1 Independence PT Ste 212
Greenville, SC 29615-4536
Phone (864) 797-6015
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10901 | SC | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149465600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1516838400000",
"number": "1114966165",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 INDEPENDENCE PT STE 212",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296154536",
"telephone_number": "864-797-6015"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "67 CREEKSIDE PARK CT",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296154810",
"telephone_number": "864-242-4602",
"fax_number": "864-242-0129"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOUKEDES",
"first_name": "CHRIS",
"middle_name": "GEORGE",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-05",
"last_updated": "2018-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "SC",
"license": "10901",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greenville, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.