Jennifer Harmon Boudreaux

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

NP95013036 Issued in CA

Practice address

1441 Liberty St
Redding, CA 96001-0811

Phone

(530) 224-2700

Fax

(530) 224-2738

NPI assigned

Nov 26, 2019

Last updated

Nov 26, 2019By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AL

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

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

American Family Care, LLCGroup PAC ID 9739087818, 180 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• American Family Care, LLC

  • Primary Care Clinic/Center
  • Birmingham, AL
  • NPI 1669429080
  Medicare reassignment Care Compare group NPD
• American Family Care, LLC

  • Family Medicine Physician
  • Vestavia Hills, AL
  • NPI 1265210645
  NPD

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

{
    "created_epoch": "1574726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574726400000",
    "number": "1275179012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1441 LIBERTY ST",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960010811",
            "telephone_number": "530-224-2700",
            "fax_number": "530-224-2738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 LIBERTY ST",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960010811",
            "telephone_number": "530-224-2700",
            "fax_number": "530-224-2738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUDREAUX",
        "first_name": "JENNIFER",
        "middle_name": "HARMON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-26",
        "last_updated": "2019-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP95013036",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF REGISTERED NURSING",
            "identifier": "NP95013036",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeffrey A Bosworth, MD
• Melanie Bosworth
• Tiffany Bosworth
• Dacia Michelle Bouchard-Horn, LVN
• Brenda Boudreaux
• Kaila Bourne
• Sia Bow
• Thomas Adam Bowen, D.O.
• Travis Winston Bowen
• Stephen Bowers, PHARMD

• Family Nurse Practitioner in Redding, CA
• Providers in Redding, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.