Individual provider Active NPI

Nancy Bouloute, ARNP

  • Family Nurse Practitioner
  • North Miami, FL
National Provider Identifier
1265984991
Registry record updated Oct 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP9172600 Issued in FL
Practice address
888 NE 126TH St
Suite 101
North Miami, FL 33161-4964
Phone
(305) 899-1406
Fax
(305) 899-1352
NPI assigned
Oct 28, 2016
Last updated
Oct 28, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X ARNP9172600 FL Primary

Addresses

Primary practice location

888 NE 126TH St
Suite 101
North Miami, FL 33161-4964

Mailing address

888 NE 126TH St
Suite 101
North Miami, FL 33161-4964
Phone (305) 899-1406

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180322000962 FL Practitioner - Nurse Practitioner 9638459514 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Gilbert Leung MD PA CurrentSince Dec 24, 2017 Accepting new patients

Locations

888 NE 126th St
Ste 101
North Miami, FL 33161
Phone (305) 899-1406

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1477612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477612800000",
    "number": "1265984991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "888 NE 126TH ST",
            "address_2": "SUITE 101",
            "city": "NORTH MIAMI",
            "state": "FL",
            "postal_code": "331614964",
            "telephone_number": "305-899-1406",
            "fax_number": "305-899-1352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "888 NE 126TH ST",
            "address_2": "SUITE 101",
            "city": "NORTH MIAMI",
            "state": "FL",
            "postal_code": "331614964",
            "telephone_number": "305-899-1406",
            "fax_number": "305-899-1352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOULOUTE",
        "first_name": "NANCY",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-28",
        "last_updated": "2016-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9172600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Miami, FL

Sources for this page

Verify at the official NPI Registry.