Matthew Bougie

Primary specialty

Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X

License

22600 Issued in WI

Practice address

130 2ND St
Neenah, WI 54956-2883

Phone

(920) 725-2070

NPI assigned

Aug 8, 2025

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

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": "1754611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754611200000",
    "number": "1619852654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W142N10576 MAGNOLIA DR",
            "city": "GERMANTOWN",
            "state": "WI",
            "postal_code": "530226217",
            "telephone_number": "414-315-6199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 2ND ST",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549562883",
            "telephone_number": "920-725-2070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUGIE",
        "first_name": "MATTHEW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-08-08",
        "last_updated": "2025-08-08",
        "certification_date": "2025-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "WI",
            "license": "22600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eric Kenneth Bogaart, D.C
• Adrienne K Bohn, PA-C
• Elizabeth Bonson, PT
• Sanjana Boosa Manmohan
• Jerome E Bormes, MD
• Bouressa Dental Associates, S.C.
• Michael J Bouressa, DDS
• Kenneth L Branstetter, M.D.
• Kelly Branstrom, NP
• Breast Surgery Experts of Northeast Wisconsin, LLC

• All providers in Neenah, WI
• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2025; 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.