Kelley Elizabeth Smith Bouchard, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

C-APN.0000381-C-NP Issued in CO

Practice address

3225 International Circle Suite 220
Colorado Springs, CO 80910

Phone

(719) 694-8956

Fax

(719) 418-3578

NPI assigned

Aug 24, 2015

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 TX

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

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Travis County Emergency Physicians PAGroup PAC ID 0840289468, 289 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kbouchard161583@directhoustonmethodist.org
• FHIR API: https://api.platform.athenahealth.com/13315/brand/1/csg/1/fhir/r4

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.

• Travis County Emergency Physicians PA

  • Emergency Medicine Physician
  • Austin, TX
  • NPI 1962440933
  Medicare reassignment Care Compare group NPD
• Springs Medical Associates, PC

  • Family Medicine Physician
  • Colorado Springs, CO
  • NPI 1982013082
  NPD (past)
• Camino Real Emergency Physicians PLLC

  • Emergency Medicine Physician
  • Livingston, TX
  • NPI 1992871966
  NPD (past)
• Methodist Health Centers

  • General Acute Care Hospital
  • Cypress, TX
  • NPI 1629828405
  NPD (past)
• Texas Emergency Room Services PA

  • Emergency Medicine Physician
  • Lufkin, TX
  • NPI 1992843387
  NPD (past)

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

{
    "created_epoch": "1440374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440374400000",
    "number": "1376910521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3225 INTERNATIONAL CIRCLE SUITE 220",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "80910",
            "telephone_number": "719-694-8956",
            "fax_number": "719-418-3578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3225 INTERNATIONAL CIRCLE SUITE 220",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "80910",
            "telephone_number": "719-694-8956",
            "fax_number": "719-418-3578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUCHARD",
        "first_name": "KELLEY",
        "middle_name": "ELIZABETH SMITH",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-24",
        "last_updated": "2015-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "C-APN.0000381-C-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Catherine Jane Bottorff, DPT
• Joshua Lawton Bottorff, PT
• Botts Therapeutic Massage, LLC
• Ashleigh Rose Botts, LMT, CNMT
• Cydney Boubon, LMT, CNMT
• Donya Joanne Boudeman, LPC
• Anthony Boudreau, AGPCNP
• Katherine Boudreaux, PHARM. D.
• Susan L Boudreaux, LMFT
• Boulder and the Pine Wellness

• Family Nurse Practitioner in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Family Nurse Practitioner in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2015; 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.