Anthony Boudreau, AGPCNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

APN.0998339-NP Issued in CO

Practice address

559 Vincent St
Colorado Springs, CO 80914-1541

Phone

(719) 556-1128

NPI assigned

Jan 6, 2023

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Renue U Medspa PCGroup PAC ID 2769878313, 3 clinicians

Front Range Wound Care PCGroup PAC ID 5496133951, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Front Range Wound Care PC

  • Allergy & Immunology Physician
  • Centennial, CO
  • NPI 1881341816
  Medicare reassignment Care Compare group NPD
• Renue U Medspa PC

  • Family Nurse Practitioner
  • Colorado Springs, CO
  • NPI 1811658289
  Medicare reassignment Care Compare group NPD
• Renue U Medspa PC

  • Durable Medical Equipment & Medical Supplies
  • Colorado Springs, CO
  • NPI 1174336127
  NPD

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

{
    "created_epoch": "1672963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672963200000",
    "number": "1558075432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "559 VINCENT ST",
            "city": "PETERSON SPACE FORCE BASE",
            "state": "CO",
            "postal_code": "80914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "559 VINCENT ST",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809141541",
            "telephone_number": "719-556-1128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUDREAU",
        "first_name": "ANTHONY",
        "credential": "AGPCNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-01-06",
        "last_updated": "2023-01-06",
        "certification_date": "2023-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CO",
            "license": "APN.0998339-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "ASIMS",
            "affiliation": "N",
            "address_1": "559 Vincent St",
            "city": "Colorado Springs",
            "state": "CO",
            "country_code": "US",
            "postal_code": "809141541",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Botts Therapeutic Massage, LLC
• Ashleigh Rose Botts, LMT, CNMT
• Cydney Boubon, LMT, CNMT
• Kelley Elizabeth Smith Bouchard, NP-C
• Donya Joanne Boudeman, LPC
• Katherine Boudreaux, PHARM. D.
• Susan L Boudreaux, LMFT
• Boulder and the Pine Wellness
• Julia Boulton, LPC
• Mark Boulware, M.D.

• Nurse Practitioner in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Nurse Practitioner in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.