Active NPI
Brenda Boucher
- Occupational Therapy Assistant
- Westford, MA
National Provider Identifier
1356722730
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 1049
- Practice address
- 3 Park Dr
Westford, MA 01886-3511 - Phone
- (978) 392-1144
- NPI assigned
- Jun 11, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 1049 | MA | Primary |
Addresses
Primary practice location
3 Park Dr
Westford, MA 01886-3511
Mailing address
3 Park Dr
Westford, MA 01886-3511
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1049 | Other | MA | BOARD OF ALLIED HEALTH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1049 | MA | MD | Audiologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1433980800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1433980800000",
"number": "1356722730",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3 PARK DR",
"city": "WESTFORD",
"state": "MA",
"postal_code": "018863511"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3 PARK DR",
"city": "WESTFORD",
"state": "MA",
"postal_code": "018863511",
"telephone_number": "978-392-1144"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOUCHER",
"first_name": "BRENDA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-06-11",
"last_updated": "2015-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "MA",
"license": "1049",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BOARD OF ALLIED HEALTH",
"identifier": "1049",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Westford, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.