Allister M Boustred, MD

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

45791 Issued in CO

Practice address

2315 E Harmony Rd
Suite 160
Fort Collins, CO 80528-8620

Phone

(970) 493-8800

Fax

(970) 498-8800

NPI assigned

Apr 25, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232668800000",
    "number": "1538125083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2315 E HARMONY RD",
            "address_2": "SUITE 160",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805288620",
            "telephone_number": "970-493-8800",
            "fax_number": "970-498-8800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2315 E HARMONY RD",
            "address_2": "SUITE 160",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805288620",
            "telephone_number": "970-493-8800",
            "fax_number": "970-498-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUSTRED",
        "first_name": "ALLISTER",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-25",
        "last_updated": "2009-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "CO",
            "license": "45791",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "87736730",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Deborah D Bothwell, CAC III
• Jolie Beth Boudreaux, L.P.C
• Boulder Pride Dba Rocky Mountain Equality
• Deborah Bourgeois, MA
• Ruth Bourke, CAS
• Amanda C Bowden, MD
• Helen F Bowden, PH.D.
• Cara Bowen, PHD, LPC
• Julie Bower
• Emma Bowers, RBT

• Plastic Surgery Physician in Fort Collins, CO
• Providers in Fort Collins, CO by specialty
• Plastic Surgery Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2009; 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.