Gerard E. Boutin PHD PA

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY0002716 Issued in FL

Legal business name

GERARD E. BOUTIN PHD PA

Practice address

13787 Belcher Rd S
140
Largo, FL 33771-4065

Phone

(727) 452-5083

NPI assigned

Jan 23, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Gerard E. Boutin, PHDNPI 1083749386

Title

President

Phone

(727) 452-5083

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Gerard E Boutin, PH.D

  • Clinical Psychologist
  • Largo, FL
  • NPI 1083749386
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1358899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358899200000",
    "number": "1124366364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13787 BELCHER RD S",
            "address_2": "140",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337714065",
            "telephone_number": "727-452-5083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13787 BELCHER RD S",
            "address_2": "140",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337714065",
            "telephone_number": "727-452-5083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GERARD E. BOUTIN PHD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-23",
        "last_updated": "2013-01-23",
        "status": "A",
        "authorized_official_last_name": "BOUTIN",
        "authorized_official_first_name": "GERARD",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "727-452-5083",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "FL",
            "license": "PY0002716",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY0002716",
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "FL",
            "license": "PY0002716",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristi Geiger, PAC
• Lindsey Michelle Geiger
• Mina Geneidy
• Ginger Gibbs Gentzel, RPH
• Heather George, PTA
• Wessam Gerguis, M.D
• Kathryn Gerlach
• Oleksandra Gerus, DO
• Mary Ann Giandonato, PHARMD
• Maria Gianfilippo, SLP

• Clinical Psychologist in Largo, FL
• Providers in Largo, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.