Gregory Boucher, D.O.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

LL176 Issued in SC

Practice address

96 Jonathan Lucas St
Musc Department of Surgery
Charleston, SC 29425-8900

Phone

(843) 792-3072

NPI assigned

Jul 22, 2008

Last updated

Jul 22, 2008By the provider in NPPES

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

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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.

• NPI 1558925735

  • NPI 1558925735
  NPD (past)

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

{
    "created_epoch": "1216684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216684800000",
    "number": "1295990042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "96 JONATHAN LUCAS ST",
            "address_2": "MUSC DEPARTMENT OF SURGERY",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294258900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "96 JONATHAN LUCAS ST",
            "address_2": "MUSC DEPARTMENT OF SURGERY",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294258900",
            "telephone_number": "843-792-3072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUCHER",
        "first_name": "GREGORY",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-22",
        "last_updated": "2008-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "SC",
            "license": "LL176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany Barefoot Bostic
• Emily Ryan Bott, OTD, OTR/L
• Jamison Scott Bottomley, PHD
• Kathryn Ann Bottonari, PH.D.
• Peter Elliott Botzis, MD
• Noelle Paige Boudreau, PA
• Lauren Boudreaux
• Christina L Bourne, MD
• David Clarke Bourque, PA-C
• Ashley Boustany, MD

• Surgery Physician in Charleston, SC
• Providers in Charleston, SC by specialty
• Surgery Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2008; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.