Kaylea Marie Boutwell, M.D.

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

License

2009025407 Issued in MO

Practice address

14825 N Outer 40 Rd
Suite 360
Chesterfield, MO 63017-2152

Phone

(314) 336-2570

Fax

(314) 336-2571

NPI assigned

Jun 20, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: clinical@katalystmd.directbygreenway.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Excel Orthopedics LLC

  • Orthopaedic Surgery Physician
  • Chesterfield, MO
  • NPI 1821423385
  NPD (past)
• Pain and Rehabilitation Specialists of St. Louis

  • Multi-Specialty Clinic/Center
  • Chesterfield, MO
  • NPI 1477880581
  NPD (past)

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

{
    "created_epoch": "1182297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259020800000",
    "number": "1144425083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14825 N OUTER 40 RD",
            "address_2": "SUITE 360",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630172152",
            "telephone_number": "314-336-2570",
            "fax_number": "314-336-2571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14825 N OUTER 40 RD",
            "address_2": "SUITE 360",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630172152",
            "telephone_number": "314-336-2570",
            "fax_number": "314-336-2571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUTWELL",
        "first_name": "KAYLEA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-20",
        "last_updated": "2009-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MO",
            "license": "2009025407",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "MO",
            "license": "2009025407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Douglas Allen Bouldin, FNP-C
• Katherine Bourgerie
• Michelle Bourke
• Bourn and Associates, P.C.
• Pamela Boutaugh
• Latonya Bowens, LCSW
• Maryellen Bowman, N.P.
• Lisa Corkery Boyce, CRNA
• Robert William Boyle, D.M.D.
• Danielle Bozzardi-Jerome, PHARM.D.

• Interventional Pain Medicine Physician in Chesterfield, MO
• Providers in Chesterfield, MO by specialty
• Interventional Pain Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2009; 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.