Individual provider Active NPI

Cindy A Bouchard, D.C.

  • Chiropractor
  • Caribou, ME
National Provider Identifier
1376688200
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CR1098 Issued in ME
Practice address
42 High St
Caribou, ME 04736-2709
Phone
(207) 493-0900
Fax
(207) 493-7800
NPI assigned
Feb 20, 2007
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CR1098 ME Primary

Addresses

Primary practice location

42 High St
Caribou, ME 04736-2709

Mailing address

42 High St
Caribou, ME 04736-2709
Phone (207) 493-0900

Other identifiers 1

IdentifierTypeStateIssuer
034516OtherMEANTHEM BLUECROSS AND BLUE

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
CR1098MEMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1376688200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 HIGH ST",
            "city": "CARIBOU",
            "state": "ME",
            "postal_code": "047362709",
            "telephone_number": "207-493-0900",
            "fax_number": "207-493-7800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 HIGH ST",
            "city": "CARIBOU",
            "state": "ME",
            "postal_code": "047362709",
            "telephone_number": "207-493-0900",
            "fax_number": "207-493-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUCHARD",
        "first_name": "CINDY",
        "middle_name": "A",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-20",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ME",
            "license": "CR1098",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUECROSS AND BLUE",
            "identifier": "034516",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Caribou, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.