Patricia Boucher, N.P.

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

RN172200 Issued in MA

Practice address

65 Libby St
Brockton, MA 02302-2949

Phone

(508) 584-6060

NPI assigned

Jul 7, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/DIJIBA

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.

• Brockton Pediatrics

  • Primary Care Clinic/Center
  • Brockton, MA
  • NPI 1629001904
  NPD (past)
• Southeast Medical Group, P.C.

  • Family Medicine Physician
  • Alpharetta, GA
  • NPI 1235296054
  NPD (past)

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

{
    "created_epoch": "1278460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278460800000",
    "number": "1194037119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 LIBBY ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023022949",
            "telephone_number": "508-584-6060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 LIBBY ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023022949",
            "telephone_number": "508-584-6060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUCHER",
        "first_name": "PATRICIA",
        "name_prefix": "Mrs.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-07",
        "last_updated": "2010-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "MA",
            "license": "RN172200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bostonva Health Care System
• Jacki M Boswell, LMHC
• Casey L Botelho, OTR/L
• Abigail Bouchard
• Jordan Lynn Boucher, RD
• Boucher'S Opticians of Brockton, Inc.
• Jennifer Marie Bouck, BS
• Bricen Boudreault
• Yvelande Boursiquot, LICSW
• Jessica Boutin, MSOTR/L, WCC

• Pediatric Adolescent Medicine Physician in Brockton, MA
• Providers in Brockton, MA by specialty
• Pediatric Adolescent Medicine Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2010; 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.