Roger Bert Boutwell, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

01984 Issued in GA

Practice address

3434 University Ave
Columbus, GA 31907

Phone

(706) 569-6996

Fax

(706) 569-8898

NPI assigned

Apr 25, 2007

Sex

Male

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)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Boutwell Chiropractic Center LLC

  • Chiropractor
  • Columbus, GA
  • NPI 1184871923
  NPD (past) Authorized official

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396964250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3434 UNIVERSITY AVE",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "31907",
            "telephone_number": "706-569-6996",
            "fax_number": "706-569-8898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3434 UNIVERSITY AVE",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "31907",
            "telephone_number": "706-569-6996",
            "fax_number": "706-569-8898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUTWELL",
        "first_name": "ROGER",
        "middle_name": "BERT",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "01984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sharian Bourgeois
• Ricardo Stephann Bourgoin, PHARMD
• Earlissa Bourne
• Paula Boutin, LPN
• Boutwell Chiropractic Center LLC
• Kara Bowden
• Leah Bowden, FNP
• Derrick Bowen
• Demonte Bowens
• Ida Bowens

• Chiropractor in Columbus, GA
• Providers in Columbus, GA by specialty
• Chiropractor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.