Denise Jean Boudreaux-Nippert, MD

Key facts

NPI

1497862031

Entity type

Individual (NPI type 1)

Primary specialty

Obstetrics & Gynecology Physician 207V00000X

License

5414306-1205 (UT)

Practice address

3584 W 9000 S
Suite 206
West Jordan, UT 84088-5710

Phone

(801) 561-2227

Fax

(801) 561-5353

NPI assigned

Aug 23, 2006

Sex

Female

Sole proprietor

No

Organizations & group practices 4

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.

• Jordan River Women'S Health, P.C. Obstetrics & Gynecology Physician · West Jordan, UT · NPI 1699732123
  Medicare reassignment Care Compare group NPD OBSTETRICS & GYNECOLOGY · UT
• Ihc Health Services Inc Multi-Specialty Clinic/Center · Sandy, UT · NPI 1942325154
  Medicare reassignment NPD UT
• Ihc Health Services Inc Internal Medicine Physician · Murray, UT · NPI 1811329154
  NPD
• Ihc Health Services, Inc. Psychiatry Physician · St George, UT · NPI 1023843844
  NPD

Medicare Care Compare profile

Specialty

Obstetrics/Gynecology

Education

Texas a & M University System, HSC, College of Medicine, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jordan River Women'S Health, P.C. (4 clinicians)

Practice addresses (Care Compare)

Medicare participation

Medicare fee-for-service enrollment

Enrolled in UT

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Doctor of Medicine

Practice roles

Locations

Specialties & licenses

Addresses

Other identifiers

Other names

• Denise J. Boudreaux Former name

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 31, 2010.

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283212800000",
    "number": "1497862031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3584 W 9000 S",
            "address_2": "SUITE 206",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840885710",
            "telephone_number": "801-561-2227",
            "fax_number": "801-561-5353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3584 W 9000 S",
            "address_2": "SUITE 206",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840885710",
            "telephone_number": "801-561-2227",
            "fax_number": "801-561-5353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUDREAUX-NIPPERT",
        "first_name": "DENISE",
        "middle_name": "JEAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-23",
        "last_updated": "2010-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "UT",
            "license": "5414306-1205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8462897",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "247321",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & IND. WA STATE",
            "identifier": "212969",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRIME VICTIMS WA STATE",
            "identifier": "8942479",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DENISE",
            "last_name": "BOUDREAUX",
            "middle_name": "J.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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All providers in West Jordan, UT · Obstetrics & Gynecology Physician in Utah