Joseph R Boudreau, M.D.

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

4016 Issued in SD

Practice address

2009 Locust St
Yankton, SD 57078-2030

Phone

(605) 689-1100

Fax

(605) 689-1104

NPI assigned

Aug 16, 2007

Sex

Male

Sole proprietor

Yes

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)

Enrolled

Credentials

Doctor of Medicine

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.

• Lewis & Clark Specialty Hospital LLC

  • Clinic/Center
  • Yankton, SD
  • NPI 1134471527
  NPD (past)

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

{
    "created_epoch": "1187222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326412800000",
    "number": "1265624878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2009 LOCUST ST",
            "city": "YANKTON",
            "state": "SD",
            "postal_code": "570782030",
            "telephone_number": "605-689-1100",
            "fax_number": "605-689-1104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2009 LOCUST ST",
            "city": "YANKTON",
            "state": "SD",
            "postal_code": "570782030",
            "telephone_number": "605-689-1100",
            "fax_number": "605-689-1104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUDREAU",
        "first_name": "JOSEPH",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-16",
        "last_updated": "2012-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "SD",
            "license": "4016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joshua Jacob Blom
• Renee A. Boehrns, PA-C
• Kimberly Kari Bornitz, PTA
• Borowski Family Dentistry PLLC
• Theophilus Borketey Bortier, MD
• Alison Boughn, PHD
• Justin Lee Boulware
• Collette Bowman
• Shanna Brahmer
• Stacy A Brandt, APRN-NP

• All providers in Yankton, SD
• Urology Physician in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2012; 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.