Cheryl Bouschard, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT017564 Issued in OH

Practice address

88TH Medical Group
4881 Sugar Maple Drive
Wright-Patterson Afb, OH 45433

Phone

(937) 257-8753

NPI assigned

Jul 10, 2015

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)

Enrolled

State licenses

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

{
    "created_epoch": "1436486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600646400000",
    "number": "1295119162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "88 MDG/SGHJ",
            "address_2": "4881 SUGAR MAPLE DRIVE",
            "city": "WRIGHT-PATTERSON AFB",
            "state": "OH",
            "postal_code": "45433",
            "telephone_number": "937-257-8753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "88TH MEDICAL GROUP",
            "address_2": "4881 SUGAR MAPLE DRIVE",
            "city": "WRIGHT-PATTERSON AFB",
            "state": "OH",
            "postal_code": "45433",
            "telephone_number": "937-257-8753"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3016 Far Hills Ave",
            "address_purpose": "LOCATION",
            "city": "Kettering",
            "state": "OH",
            "postal_code": "45429",
            "country_code": "US",
            "telephone_number": "937-886-4275",
            "fax_number": "937-886-4278",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOUSCHARD",
        "first_name": "CHERYL",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-10",
        "last_updated": "2020-09-21",
        "certification_date": "2020-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT017564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aditya Avinash Bhagwat, PH.D.
• Melissa Ann Bizzarro, RD,LD
• Darryll W. Black, PA-C
• Peter Nolan Bonneau, MD
• Rodney Bosserman, IDMT
• Stacey Lynn Branch, DO, MPH
• Austin Brokamp
• Hyrum Ray Bronson, D.O.
• Daniel James Brown, M.D.
• James Wellington Brown, MD

• Physical Therapist in Wright-Patterson Afb, OH
• Providers in Wright-Patterson Afb, OH by specialty
• Physical Therapist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2020; 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.