Jessica Boutin, MSOTR/L, WCC

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

11366 Issued in MA

Practice address

940 Belmont St
Brockton, MA 02301-5568

Phone

(774) 826-1811

NPI assigned

Oct 4, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1507075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585267200000",
    "number": "1578073557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 THURLOW ST",
            "city": "GEORGETOWN",
            "state": "MA",
            "postal_code": "018331132",
            "telephone_number": "978-430-5367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "940 BELMONT ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023015568",
            "telephone_number": "774-826-1811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUTIN",
        "first_name": "JESSICA",
        "credential": "MSOTR/L, WCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-04",
        "last_updated": "2020-03-27",
        "certification_date": "2020-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MA",
            "license": "332720",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NH",
            "license": "2433",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MA",
            "license": "11366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia Boucher, N.P.
• Boucher'S Opticians of Brockton, Inc.
• Jennifer Marie Bouck, BS
• Bricen Boudreault
• Yvelande Boursiquot, LICSW
• Shelby Bowling
• Taylor Irene Boyce, FNP
• Tara Boyd, BS,CCLS
• Daniel P. Bradley, LICSW
• John C Bradley, M.D.

• Occupational Therapist in Brockton, MA
• Providers in Brockton, MA by specialty
• Occupational Therapist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2020; 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.