Anne Rosette Bouele Mboule, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

P6342 Issued in TX

Practice address

2301 N Collins St
Suite 100
Arlington, TX 76011-2659

Phone

(817) 704-7339

Fax

(682) 558-8008

NPI assigned

Jul 3, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 3

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WI

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: anne.bouele.mboule@marshfieldclinichealthsystem.cernerdirect.com
• Direct secure messaging: him@marshfieldclinichealthsystem.cernerdirect.com

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.

• Marshfield Clinic Inc

  dba Marshfield Clinic Florida Teleradiology/Telehealth

  • Clinic/Center
  • Marshfield, WI
  • NPI 1952347981

  Multi-Specialty

  Medicare reassignment NPD
• MCHS Hospitals Inc

  dba Marshfield Medical Center

  • Clinic/Center
  • Marshfield, WI
  • NPI 1093221434

  Multi-Specialty

  Medicare reassignment NPD
• MCHS Hospitals Inc

  dba Marshfield Medical Center - Eau Claire Cancer Center

  • Durable Medical Equipment & Medical Supplies
  • Eau Claire, WI
  • NPI 1558230847
  NPD
• MCHS Hospitals, Inc.

  dba Marshfield Medical Center Ladysmith

  • Medicare Defined Swing Bed Hospital Unit
  • Ladysmith, WI
  • NPI 1346716263

  Multi-Specialty

  NPD

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

{
    "created_epoch": "1183420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617235200000",
    "number": "1700084555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 N COLLINS ST",
            "address_2": "SUITE 100",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760112659",
            "telephone_number": "817-704-7339",
            "fax_number": "682-558-8008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 N COLLINS ST",
            "address_2": "SUITE 100",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760112659",
            "telephone_number": "817-704-7339",
            "fax_number": "682-558-8008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUELE MBOULE",
        "first_name": "ANNE",
        "middle_name": "ROSETTE",
        "name_prefix": "Miss",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-03",
        "last_updated": "2021-04-01",
        "certification_date": "2021-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AL",
            "license": "29656",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "P6342",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "218565403",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "116029",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "218565401",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "him@marshfieldclinichealthsystem.cernerdirect.com",
            "affiliation": "N",
            "address_1": "2301 N Collins St",
            "address_2": "Suite 100",
            "city": "Arlington",
            "state": "TX",
            "country_code": "US",
            "postal_code": "760112659",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Catrena Y Boswell, LCSW
• Rodney Jerome Boswell, CSFA
• Jacqueline Botts, D.C.
• Elizabeth Grace Boudreau, PT, DPT
• Sonia Boudreaux
• William Gordon Bourland II, PH.D.
• Caitlin Anna Bourne, CPM, LM
• Kelsey Bowen
• Lamar Wallace Bowens
• Benjamin L. Bowers, M.D

• Pediatrics Physician in Arlington, TX
• Providers in Arlington, TX by specialty
• Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.