Individual provider Active NPI

Brice T. Boughner, MD

  • Diagnostic Radiology Physician
  • Columbia, TN
National Provider Identifier
1669428603
Registry record updated Aug 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
44452 Issued in TN
Practice address
1224 Trotwood Ave
Columbia, TN 38401-4802
Phone
(931) 381-1111
Fax
(931) 552-6663
NPI assigned
May 25, 2006
Last updated
Aug 4, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 18552 MS
Diagnostic Radiology Physician 2085R0202X 44452 TN Primary

Addresses

Primary practice location

1224 Trotwood Ave
Columbia, TN 38401-4802

Mailing address

PO Box 3239
Indianapolis, IN 46206-3239
Phone (844) 295-4871

Other practice location 1

5421 Main St
Spring Hill, TN 37174-4410
Phone (615) 577-4057

Other identifiers 2

IdentifierTypeStateIssuer
P00687770OtherTNRAILROAD MEDICARE
30027211MedicaidTN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bboughner@sratn.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090312000460 TN Practitioner - Diagnostic Radiology 4981505013 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Tennessee, HSC, College of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern Radiology Associates PLLCGroup PAC ID 7214913649, 41 clinicians
Spring Hill Imaging Center, LLCGroup PAC ID 3577666536, 16 clinicians

Practice addresses (Care Compare)

103 JV Mangubat Dr
Waynesboro, TN 38485-2440
Phone (931) 722-5411

1224 Trotwood Ave
Columbia, TN 38401-4802
Phone (931) 381-1111

3316 Hwy 43
Suite 102
Ethridge, TN 38456-2136
Phone (931) 244-6090

5421 Main St
Suite C
Spring Hill, TN 37174-4410
Phone (931) 486-3425

854 W James M Campbell Blvd
Suite 403
Columbia, TN 38401-4659
Phone (931) 380-0075

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.31 of 100Reported as group
Quality
94.63
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
91.58 of 100Reported as group
Quality
83.16
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
18552MSMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Spring Hill Imaging Center LLC CurrentSince Feb 1, 2009 Accepting new patients
Southern Radiology Associates, PLLC Diagnostic Radiology CurrentSince Feb 1, 2009 Accepting new patients
Shands Teaching Hospital and Clinics Inc Past Accepting new patients

Locations

1224 Trotwood Ave
Columbia, TN 38401
Phone (931) 380-4072

2718 Squirrel Hollow Dr
Linden, TN 37096
Phone (931) 587-2121

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628035200000",
    "number": "1669428603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3239",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462063239",
            "telephone_number": "844-295-4871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1224 TROTWOOD AVE",
            "city": "COLUMBIA",
            "state": "TN",
            "postal_code": "384014802",
            "telephone_number": "931-381-1111",
            "fax_number": "931-552-6663"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5421 Main St",
            "address_purpose": "LOCATION",
            "city": "Spring Hill",
            "state": "TN",
            "postal_code": "371744410",
            "country_code": "US",
            "telephone_number": "615-577-4057",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOUGHNER",
        "first_name": "BRICE",
        "middle_name": "T.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-25",
        "last_updated": "2021-08-04",
        "certification_date": "2021-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MS",
            "license": "18552",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TN",
            "license": "44452",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00687770",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30027211",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bboughner@sratn.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Health information service provider",
            "address_1": "5421 Main St",
            "city": "Spring Hill",
            "state": "TN",
            "country_code": "US",
            "postal_code": "371744410",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Columbia, TN

Sources for this page

Verify at the official NPI Registry.