Kristen Marie Boucher, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CHIR009807 Issued in GA

Practice address

124 Chapel Crossing Rd
Brunswick, GA 31525-0529

Phone

(912) 554-2002

Fax

(912) 554-2290

NPI assigned

Sep 6, 2011

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

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

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 and National Provider Directory roles.

• Atlas Chiropractic of Syracuse

  • Chiropractor
  • Syracuse, NY
  • NPI 1578904272
  NPD (past)
• Atlas Chiropractic Services, P.C.

  • Chiropractor
  • Syracuse, NY
  • NPI 1013189430
  NPD (past)

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

{
    "created_epoch": "1315267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565222400000",
    "number": "1255612180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "174 RIVER BIRCH LN",
            "city": "MIDWAY",
            "state": "GA",
            "postal_code": "313205356",
            "telephone_number": "315-373-4346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 CHAPEL CROSSING RD",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315250529",
            "telephone_number": "912-554-2002",
            "fax_number": "912-554-2290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUCHER",
        "first_name": "KRISTEN",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-06",
        "last_updated": "2019-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR009807",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Parameshwara Rao Bolla, MD
• Nicole Grant Bonds
• Matthew R Boothby
• Charity Christine Boree, MSN, APRN, FNP-C
• Richard Neal Boswell, MD
• Erick Bournigal, MD
• Christopher John Bovinet, D.O.
• Paul Allen Bowen II, MD
• Teah Bowen, RN SANE
• Jason Bowman, MD

• Chiropractor in Brunswick, GA
• Providers in Brunswick, GA by specialty
• Chiropractor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2019; 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.