Matthew William Bouchard, B.S.

Primary specialty

PharmacistTaxonomy code 183500000X

License

16706 Issued in NV

Practice address

6380 Polaris Ave Unit B
Las Vegas, NV 89118-3821

Phone

(702) 269-2005

Fax

(702) 269-4428

NPI assigned

Jan 31, 2013

Last updated

Jan 27, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 11

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Science

State licenses

Practice roles

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

• Nuro Pharma Inc

  • Pharmacy
  • Las Vegas, NV
  • NPI 1669725099
  NPD (past)

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

{
    "created_epoch": "1359590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390780800000",
    "number": "1215276902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6380 POLARIS AVE UNIT B",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891183821",
            "telephone_number": "702-269-2005",
            "fax_number": "702-269-4428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6380 POLARIS AVE UNIT B",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891183821",
            "telephone_number": "702-269-2005",
            "fax_number": "702-269-4428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUCHARD",
        "first_name": "MATTHEW",
        "middle_name": "WILLIAM",
        "credential": "B.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-01-31",
        "last_updated": "2014-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NV",
            "license": "16706",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST LICENSE",
            "identifier": "16706",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST LICENSE",
            "identifier": "016497",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST LICENSE",
            "identifier": "14059",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST LICENSE",
            "identifier": "202011979",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST LICENSE",
            "identifier": "20910",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST LICENSE",
            "identifier": "36982",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST LICENSE",
            "identifier": "P11976",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST LICENSE",
            "identifier": "RPH-0012926",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST LICENSE",
            "identifier": "PST.019679",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST LICENSE",
            "identifier": "PD11738",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST LICENSE",
            "identifier": "S019524",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Lawson Botts, DO
• Peter Antoune Joseph Bou-Daher, PA-C
• Brigette Boucaud
• Christina Jolie Bouchard
• Darcie Ellen Bouchard, PA-C
• Alen Boucourt
• Kadin Boudaghian
• Lemou Boudaghian
• Linda Boudaghian
• Shelly Lynn Boudell

• Pharmacist in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Pharmacist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2014; 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.