Individual provider Active NPI

Caleb James Boutte

  • Health Educator
  • Houston, TX
National Provider Identifier
1609424290
Registry record updated Aug 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health EducatorTaxonomy code 174H00000X
Practice address
3611 Ennis St
Houston, TX 77004-4407
Phone
(832) 393-4055
Fax
(832) 393-4088
NPI assigned
Aug 28, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Educator 174H00000X Primary

Addresses

Primary practice location

3611 Ennis St
Houston, TX 77004-4407

Mailing address

3611 Ennis St
Houston, TX 77004-4407
Phone (832) 393-4055

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address caleb.boutte@houstontx.gov

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1566950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566950400000",
    "number": "1609424290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3611 ENNIS ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770044407",
            "telephone_number": "832-393-4055",
            "fax_number": "832-393-4088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3611 ENNIS ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770044407",
            "telephone_number": "832-393-4055",
            "fax_number": "832-393-4088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUTTE",
        "first_name": "CALEB",
        "middle_name": "JAMES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-28",
        "last_updated": "2019-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174H00000X",
            "taxonomy_group": "",
            "desc": "Health Educator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "caleb.boutte@houstontx.gov",
            "affiliation": "N",
            "address_1": "3611 Ennis St",
            "city": "Houston",
            "state": "TX",
            "country_code": "US",
            "postal_code": "770044407",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2019; 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.