Linda K Boughton, NP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

571139 Issued in TX

Practice address

1500 S Main St
Fort Worth, TX 76104-4917

Phone

(817) 921-3431

NPI assigned

Jun 23, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Linda K Hicks Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• JPS Physician Group Inc

  • General Acute Care Hospital
  • Fort Worth, TX
  • NPI 1184619082
  NPD (past)

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351555200000",
    "number": "1699701649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 S MAIN ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044917",
            "telephone_number": "817-921-3431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 S MAIN ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044917",
            "telephone_number": "817-921-3431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUGHTON",
        "first_name": "LINDA",
        "middle_name": "K",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-23",
        "last_updated": "2012-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "571139",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "044387103",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LINDA",
            "last_name": "HICKS",
            "middle_name": "K",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Joyce Botchey-Niiquaye, FNP
• Marina Botros
• Mary Claire Boudreaux, M.S. CCC-SLP
• Michelle C Boudria, NP
• Natalie Waller Bouffard-Lewis, M.S., LPC
• Kelly Davenport Boulden, M.D.
• Carole-Anne Bouldin, MD
• Melissa Diane Boulware, PHARMD
• Robert Matthew Boulware, PHARM.D.
• Jill Erin Bounds, MA, LPC, LMFT

• Pediatric Nurse Practitioner in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Pediatric Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.