Individual provider Active NPI

Brian P Bouton, M.D.

  • Psychiatry Physician
  • Ruckersville, VA
National Provider Identifier
1164580130
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
0101024519 Issued in VA
Practice address
1552 Sunflower Fields Dr
Ruckersville, VA 22968-1511
Phone
(434) 973-3090
NPI assigned
Dec 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 0101024519 VA Primary
Child & Adolescent Psychiatry Physician 2084P0804X 0101024519 VA

Addresses

Primary practice location

1552 Sunflower Fields Dr
Ruckersville, VA 22968-1511

Mailing address

1552 Sunflower Fields Dr
Ruckersville, VA 22968-1511
Phone (434) 973-3090

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101024519VAMDChild & Adolescent Psychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1164580130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1552 SUNFLOWER FIELDS DR",
            "city": "RUCKERSVILLE",
            "state": "VA",
            "postal_code": "229681511",
            "telephone_number": "434-973-3090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1552 SUNFLOWER FIELDS DR",
            "city": "RUCKERSVILLE",
            "state": "VA",
            "postal_code": "229681511",
            "telephone_number": "434-973-3090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUTON",
        "first_name": "BRIAN",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-04",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VA",
            "license": "0101024519",
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "VA",
            "license": "0101024519",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ruckersville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.