Ashley Lynn Boutain, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

2183 Issued in MN

Practice address

111 17TH Ave E
Suite 101
Alexandria, MN 56308-3734

Phone

(320) 762-1144

Fax

(320) 762-1935

NPI assigned

Nov 19, 2009

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1258588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397779200000",
    "number": "1386972909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 17TH AVE E",
            "address_2": "SUITE 101",
            "city": "ALEXANDRIA",
            "state": "MN",
            "postal_code": "563083734",
            "telephone_number": "320-762-1144",
            "fax_number": "320-762-1935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 17TH AVE E",
            "address_2": "SUITE 101",
            "city": "ALEXANDRIA",
            "state": "MN",
            "postal_code": "563083734",
            "telephone_number": "320-762-1144",
            "fax_number": "320-762-1935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUTAIN",
        "first_name": "ASHLEY",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-19",
        "last_updated": "2014-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MN",
            "license": "2183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Athletic Trainer in Alexandria, MN
• Providers in Alexandria, MN by specialty
• Athletic Trainer in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2014; 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.