Windell C Davis-Boutte, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

039318 Issued in GA

Practice address

4650 Stone Mountain Ga
Lilburn, GA 30047

Phone

(770) 938-4001

Fax

(770) 938-4849

NPI assigned

Jun 27, 2006

Sex

Female

Sole proprietor

Yes

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

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669409298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2165 SPENCERS WAY",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300871246",
            "telephone_number": "770-938-4001",
            "fax_number": "770-938-4849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4650 STONE MOUNTAIN GA",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "30047",
            "telephone_number": "770-938-4001",
            "fax_number": "770-938-4849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS-BOUTTE",
        "first_name": "WINDELL",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "GA",
            "license": "039318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hong Dang, FNP-C
• Chenee M Daniels, RPH
• Jordan Daniels
• Aaron Davidson
• Donald Lee Davidson, PH.D.
• Carol Dawn Davis, MD
• Jeffrey William Davis, PTA
• Richard Lee Dawson
• Yolanda DS Dawson
• Emma Deal

• Dermatology Physician in Lilburn, GA
• Providers in Lilburn, GA by specialty
• Dermatology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.