Individual provider Active NPI

Linda Grace Bouchillon, PA-C

  • Physician Assistant
  • Huntington, WV
National Provider Identifier
1639852460
Registry record updated Sep 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
3077 Issued in WV
Practice address
1600 Medical Center Dr Ste G500
Huntington, WV 25701-3659
Phone
(304) 691-1262
Fax
(304) 691-1666
NPI assigned
Aug 9, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 3077 WV Primary

Addresses

Primary practice location

1600 Medical Center Dr Ste G500
Huntington, WV 25701-3659

Mailing address

1448 10TH Ave Ste 304
Huntington, WV 25701-3579
Phone (304) 733-8728

Other names 1

  • Grace Bouchillon Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address linda.bouchillon@marshall.cernerdirect.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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

Enrollment IDStateProvider typePAC IDDetails
I20251117003042 WV Practitioner - Physician Assistant 8426549510 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1600 Medical Ctr Dr
Suite G500
Huntington, WV 25701-3659
Phone (304) 691-1262

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University Physicians & Surgeons, Inc Physician Assistant CurrentSince Sep 8, 2025 Accepting new patients
University Physicians & Surgeons, Inc. CurrentSince Sep 8, 2025 Accepting new patients

Locations

1600 Medical Center Dr
Ste G500
Huntington, WV 25701
Phone (304) 691-1262

1542 Spring Valley Dr
Huntington, WV 25704
Phone (304) 691-1700

1600 Medical Center Dr
Ste 3500
Huntington, WV 25701
Phone (304) 691-1300

1448 10th Ave
Ste 304
Huntington, WV 25701
Phone (304) 691-6381

Interoperability endpoints

  • Direct secure messaging: linda.bouchillon@marshall.cernerdirect.com

Organizations & group practices 2

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1691539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757635200000",
    "number": "1639852460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1448 10TH AVE STE 304",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257013579",
            "telephone_number": "304-733-8728",
            "fax_number": "304-691-8591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 MEDICAL CENTER DR STE G500",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257013659",
            "telephone_number": "304-691-1262",
            "fax_number": "304-691-1666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUCHILLON",
        "first_name": "LINDA",
        "middle_name": "GRACE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-09",
        "last_updated": "2025-09-12",
        "certification_date": "2025-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WV",
            "license": "3077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "linda.bouchillon@marshall.cernerdirect.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1600 Medical Center Dr Ste G500",
            "city": "Huntington",
            "state": "WV",
            "country_code": "US",
            "postal_code": "257013659",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "GRACE",
            "last_name": "BOUCHILLON",
            "credential": "PA-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Huntington, WV

Sources for this page

Verify at the official NPI Registry.