Pamela Boushie
Individual provider Active NPI Registered Dietitian · Southington, CT
NPI 1205693173 · NPPES record last updated Mar 6, 2024
Key facts
- NPI
- 1205693173
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- 000743 (CT)
- Practice address
- 1131 West St Ste 2
Southington, CT 06489-6006 - Phone
- (860) 517-8888
- NPI assigned
- Mar 6, 2024
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000743 | CT | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pounds Medical Weight Loss Transformation PC | Current |
Accepting new patients | |
| Pounds, Medical Weight Loss Transformation, PC | Past |
Accepting new patients |
Locations
480 Naubuc Ave
Glastonbury, CT 06033
Phone (860) 494-2400
1131 West St
Ste 2
Southington, CT 06489
Phone (860) 276-6800
1131 West St
Ste 1
Southington, CT 06489
Phone (860) 378-2811
125 Lasalle Rd
Ste 208
West Htfd, CT 06107
Phone (860) 906-1289
Interoperability endpoints
- https://api.platform.athenahealth.com/25497/brand/1/csg/1/fhir/r4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 000743 | CT | Yes |
Addresses
Primary practice location
1131 West St Ste 2
Southington, CT 06489-6006
Mailing address
125 Lasalle Rd Ste 208
West Hartford, CT 06107-2311
Phone (860) 906-1289
Other providers in Southington, CT
- Paige Bogda
- Craig M Bogdanski
- Sophia Bolio
- Kristin Bontempi
- Rachel L Booth
- Bradley Memorial Hospital and Health Center
- Brave, LLC
- Katherine Bray
- Marie Elena Bray
- Amy Breakstone
All providers in Southington, CT · Registered Dietitian in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 6, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.