Rene Albert Boucher, DO

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

License

02561 Issued in KY

Practice address

165 Natchez Trace Ave
Suite 205
Bowling Green, KY 42103-7940

Phone

(270) 282-2024

Fax

(270) 393-1913

NPI assigned

Sep 2, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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.

• Anesthesia & Pain Specialists of Bowling Green PLC

  • Anesthesiology Physician
  • Bowling Green, KY
  • NPI 1548253107

  Anesthesiology

  NPD (past)

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

{
    "created_epoch": "1125619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253232000000",
    "number": "1699769869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 PARK ST",
            "address_2": "STE 203 B",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421011784",
            "telephone_number": "270-393-1912",
            "fax_number": "270-393-1913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 NATCHEZ TRACE AVE",
            "address_2": "SUITE 205",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421037940",
            "telephone_number": "270-282-2024",
            "fax_number": "270-393-1913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUCHER",
        "first_name": "RENE",
        "middle_name": "ALBERT",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-02",
        "last_updated": "2009-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "KY",
            "license": "02561",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "KY",
            "license": "02561",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "KY",
            "license": "02561",
            "primary": true
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "KY",
            "license": "02561",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64980105",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Will Patrick Boothe
• Matthew Boshears, RBT
• Emily Boston, CSW
• Morgan Ashley Bottoms
• Stephanie Bouchard, DO
• Kimberly Dawn Bowen, PT
• Bowling Green Anesthesiology Associates, PSC
• Bowling Green Dermatology & Skin Cancer Specialists PLLC
• Bowling Green Dialysis Center Inc
• Bowling Green Emergency Services, LLC

• All providers in Bowling Green, KY
• Interventional Pain Medicine Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2009; 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.