Christina Bouchillon, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

6116 Issued in TN

Practice address

1712 Woodpointe Dr
Knoxville, TN 37931-4923

Phone

(423) 502-0258

NPI assigned

Sep 19, 2024

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

Enrolled in TN

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

Physician Assistant

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Afc TN Medical Group PCGroup PAC ID 5193261519, 5 clinicians

Harper Medical Group, PCGroup PAC ID 5799961850, 13 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Afc TN Medical Group PC

  • Urgent Care Clinic/Center
  • Powell, TN
  • NPI 1851147888
  Medicare reassignment Care Compare group
• Harper Medical Group, PC

  • Urgent Care Clinic/Center
  • Memphis, TN
  • NPI 1518274927
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1726704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726704000000",
    "number": "1336976570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1712 WOODPOINTE DR",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379314923",
            "telephone_number": "423-502-0258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1712 WOODPOINTE DR",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379314923",
            "telephone_number": "423-502-0258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUCHILLON",
        "first_name": "CHRISTINA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-19",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "6116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Herman G Botero, D.O.
• Abigail Bottomley, N.P.
• Christy Brooke Bottoms, CNM
• Jessica Botts, LPN
• Erin Bouchard
• Joseph Robert Boughter
• Bria Wall Boukovalas, CRNA
• Stefanos Boukovalas, M.D.
• Heydon Bouldin
• Reid Boulet, DDS, MSC

• Physician Assistant in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2024; 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.