Individual provider Active NPI

Ariana Carmen Boucher, PT, DPT

  • Physical Therapist
  • Greenville, NC
National Provider Identifier
1659859643
Registry record updated Oct 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
P18176 Issued in NC
Practice address
1540 E Arlington Blvd
Greenville, NC 27858-5870
Phone
(252) 364-2806
Fax
(252) 364-2863
NPI assigned
Aug 1, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X P18176 NC Primary

Addresses

Primary practice location

1540 E Arlington Blvd
Greenville, NC 27858-5870

Mailing address

1540 E Arlington Blvd
Greenville, NC 27858-5870
Phone (252) 364-2806

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180918002123 NC Practitioner - Physical Therapist in Private Practice 9234480047 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P18176NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kinetic Phys Therapy and Wellness Inc CurrentSince Aug 25, 2021 Accepting new patients
Pelvic Bowl Rehab Physical Therapist Current Accepting new patients
Avila Physical Therapy for Womens Health PastSince Aug 1, 2018 Accepting new patients

Locations

1540 E Arlington Blvd
Greenville, NC 27858
Phone (252) 364-2806

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1533081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728000000000",
    "number": "1659859643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1540 E ARLINGTON BLVD",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278585870",
            "telephone_number": "252-364-2806",
            "fax_number": "252-364-2863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1540 E ARLINGTON BLVD",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278585870",
            "telephone_number": "252-364-2806",
            "fax_number": "252-364-2863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUCHER",
        "first_name": "ARIANA",
        "middle_name": "CARMEN",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-01",
        "last_updated": "2024-10-04",
        "certification_date": "2024-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P18176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.