Mary Jane Bouley, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

016481 Issued in NY

Practice address

37 N Union Street
Spencerport, NY 14559

Phone

(585) 349-2860

Fax

(585) 349-2995

NPI assigned

Jan 25, 2006

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

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219190400000",
    "number": "1447220140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 N UNION STREET",
            "city": "SPENCERPORT",
            "state": "NY",
            "postal_code": "14559",
            "telephone_number": "585-349-2860",
            "fax_number": "585-349-2995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37 N UNION STREET",
            "city": "SPENCERPORT",
            "state": "NY",
            "postal_code": "14559",
            "telephone_number": "585-349-2860",
            "fax_number": "585-349-2995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOULEY",
        "first_name": "MARY JANE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-25",
        "last_updated": "2008-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "016481",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHOICE",
            "identifier": "P010016481",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED CARE",
            "identifier": "103351FT",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7024316",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "P011016481",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lotus J Besemer, LPN
• Kathleen P. Blair, MSW LCSW
• Boces2
• Greta Renee Bohn, M.S., CCC/SLP
• Brianna R Borrelli, M.A.
• Nona L Bouwes, CCC-SLP
• Regina Urbanik Boyer, SLP
• Hannah Mary Bradshaw, OTR/L
• Susan J Brannen, AU.D.
• David Allen Brinkel, RPH

• Physical Therapist in Spencerport, NY
• Providers in Spencerport, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2008; 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.