Boulevard Family Practice

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

72846 Issued in GA

Legal business name

BOULEVARD FAMILY PRACTICE

Practice address

1010 Prince Ave Ste 184
Athens, GA 30606-5815

Phone

(706) 850-6134

NPI assigned

May 2, 2017

Organization subpart

No

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

Authorized official

Name

Thomas Weiner, MBBS

Title

Physician

Phone

(706) 850-6134

Specialties & licenses 2

Addresses

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Hillary Reid Newland Jr., M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Douglas, GA
  • NPI 1194709733
  NPD (past)
• Cathryn Louise Russell, M.D.

  • Family Medicine Physician
  • New York, NY
  • NPI 1245409739
  NPD (past)

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

{
    "created_epoch": "1493683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493683200000",
    "number": "1508392267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 PRINCE AVE STE 184",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306065815",
            "telephone_number": "706-850-6134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 PRINCE AVE STE 184",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306065815",
            "telephone_number": "706-850-6134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOULEVARD FAMILY PRACTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-02",
        "last_updated": "2017-05-02",
        "status": "A",
        "authorized_official_last_name": "WEINER",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "706-850-6134",
        "authorized_official_credential": "MBBS"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "72846",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "72811",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Isaac Mandoh Botchey Jr., DO
• Anne Katherine Bothe, M.A., PH.D., CCC-SLP
• Daniel J Boudreaux, MD
• Taylor Brittain Boudreaux, NP
• Boulevard Family Practice
• Dana Bour, R.N.
• Eric Steven Bour, MD
• Anne Bourbonnais, RN
• Andrea Bowden, PT, DPT
• Katelyn Hannah Bowen Morse, LMSW

• Family Medicine Physician in Athens, GA
• Providers in Athens, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2017; 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.