Kenneth R Bouchard, PH.D.

Primary specialty

Audiologist-Hearing Aid FitterTaxonomy code 237600000X

License

1601000335 Issued in MI

Practice address

6777 West Maple Road
Otolaryngology/Audiology Henry Ford W.Bloomfiled Hosp
West Bloomfield, MI 48322

Phone

(248) 925-8276

NPI assigned

Jan 16, 2007

Last updated

Oct 22, 2012By 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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Interoperability endpoints

• Direct secure messaging: kbouchard17013@direct.hfhs.org

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350864000000",
    "number": "1316098361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32411 BRIARCREST KNLS",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483341515",
            "telephone_number": "248-505-1689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6777 WEST MAPLE ROAD",
            "address_2": "OTOLARYNGOLOGY/AUDIOLOGY HENRY FORD W.BLOOMFILED HOSP",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "48322",
            "telephone_number": "248-925-8276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUCHARD",
        "first_name": "KENNETH",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-16",
        "last_updated": "2012-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "MI",
            "license": "1601000335",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AUDIOLOGIST LICENSE STATE",
            "identifier": "1601000335",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Abby Simone Bonato, M.D.
• Karen Lehman Boren, P.T,
• David Borkowski
• Bormans Inc (Farmer Jack Pharmacy)
• Ellen Bouchard
• Amy Joy Bowdich, LMSW
• Gabrielle Bowyer
• John Boyle, DO
• James B Bragman, DO
• Laura Brainard, MD

• Audiologist-Hearing Aid Fitter in West Bloomfield, MI
• Providers in West Bloomfield, MI by specialty
• Audiologist-Hearing Aid Fitter in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 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.