Laurie A Boudreaux, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

50.003687RX Issued in OH

Practice address

5308 Harroun Rd Ste 280
Sylvania, OH 43560-2190

Phone

(567) 585-2080

Fax

(567) 585-2081

NPI assigned

Jun 24, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Laurie A Arnold Other name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OH

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

Physician Assistant

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Promedica Multi Specialty PhysiciansGroup PAC ID 7113182809, 269 clinicians

Promedica Central PhysiciansGroup PAC ID 2365348190, 785 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Promedica Toledo Hospital Hospital, Toledo, OH, CCN 360068

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Promedica Central Physicians

  • Family Medicine Physician
  • Toledo, OH
  • NPI 1043270150

  Physician Assistant

  Medicare reassignment Care Compare group NPD
• Promedica Multi Specialty Physicians

  • Family Medicine Physician
  • Toledo, OH
  • NPI 1306105150
  Medicare reassignment Care Compare group
• Promedica Central Physicians

  • Durable Medical Equipment & Medical Supplies
  • Toledo, OH
  • NPI 1669068482
  NPD
• Lima Memorial Joint Operating Company

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)
• Our Lady of the Lake Physician Group LLC

  • Hematology & Oncology Physician
  • Baton Rouge, LA
  • NPI 1184671455

  Physician Assistant

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• The Toledo Hospital

  • General Acute Care Hospital
  • Toledo, OH
  • NPI 1407854771
  Care Compare affiliation
• Toledo Hospital

  • Ambulance
  • Toledo, OH
  • NPI 1427147339

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1245801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773360000000",
    "number": "1639307085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5308 HARROUN RD STE 280",
            "city": "SYLVANIA",
            "state": "OH",
            "postal_code": "435602190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5308 HARROUN RD STE 280",
            "city": "SYLVANIA",
            "state": "OH",
            "postal_code": "435602190",
            "telephone_number": "567-585-2080",
            "fax_number": "567-585-2081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUDREAUX",
        "first_name": "LAURIE",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-24",
        "last_updated": "2026-03-13",
        "certification_date": "2026-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.003687RX",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": "PA.200277",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lboudreaux12956@epicdirect.promedica.org",
            "affiliation": "N",
            "address_1": "5308 Harroun Rd Ste 280",
            "city": "Sylvania",
            "state": "OH",
            "country_code": "US",
            "postal_code": "435602190",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "LAURIE",
            "last_name": "ARNOLD",
            "middle_name": "A",
            "credential": "PA-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Alicia Boreman-Menke, LPC/CR
• Kelly Potter Borgman, PT
• Tabitha Bosinger, PA
• Raul Martin Bosio, M.D., M.S.B.S.
• Emily M Boston, LISW-S LICDC-CS
• Lauren Graham Bourell, DDS, MD
• Jarin Boyer, RN
• Meganne E. Boyer, R.N.
• Bonnie J Brahaney, CNP
• Megan Braida, BSW, LSW

• Physician Assistant in Sylvania, OH
• Providers in Sylvania, OH by specialty
• Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2026; 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.