Jessica L Boudreaux-Milligan, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

9109966 Issued in FL

Practice address

2290 W Eau Gallie Blvd Ste 210B
Melbourne, FL 32935

Phone

(321) 435-1505

NPI assigned

Mar 12, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Biocellular Therapies Inc

  • Multi-Specialty Clinic/Center
  • Melbourne, FL
  • NPI 1659841914
  NPD (past)
• Mercy Clinic Cardiovascular and Thoracic Surgery, LLC

  • Vascular Surgery Physician
  • Washington, MO
  • NPI 1528192416
  NPD (past)

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

{
    "created_epoch": "1205280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554249600000",
    "number": "1386815835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2290 W EAU GALLIE BLVD STE 210B",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329353145",
            "telephone_number": "321-435-1505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2290 W EAU GALLIE BLVD STE 210B",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "32935",
            "telephone_number": "321-435-1505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUDREAUX-MILLIGAN",
        "first_name": "JESSICA",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-12",
        "last_updated": "2019-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "9109966",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MO",
            "license": "2008006639",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven O Bossinger, MD
• Samantha Bostick
• Emma Grace Boswell
• Scott David Bosy, M.D.
• Hany Botros
• Boundless Growth Solutions, LLC
• Natalia V Bouse
• Heather Bovasso
• Kathleen Mary Bovee, NP
• Christina H Bovelsky, M.D.

• Medical Physician Assistant in Melbourne, FL
• Providers in Melbourne, FL by specialty
• Medical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2019; 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.