Individual provider Active NPI

Annie Bouchereau, MPTA

  • Physical Therapist
  • Hollywood, FL
National Provider Identifier
1710050778
Registry record updated May 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT19446 Issued in FL
Practice address
1 Oakwood Blvd Ste 130
Hollywood, FL 33020-1937
Phone
(954) 925-3844
Fax
(954) 925-3845
NPI assigned
Nov 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Therapist 222Q00000X
Physical Therapist 225100000X PT19446 FL Primary

Addresses

Primary practice location

1 Oakwood Blvd Ste 130
Hollywood, FL 33020-1937

Mailing address

1 Oakwood Blvd Ste 130
Hollywood, FL 33020-1937
Phone (954) 445-3064

Other identifiers 1

IdentifierTypeStateIssuer
886421700MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT19446FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Communication Corner and More, Inc. Physical Therapist PastSince Apr 3, 2022 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746748800000",
    "number": "1710050778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 OAKWOOD BLVD STE 130",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330201937",
            "telephone_number": "954-445-3064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 OAKWOOD BLVD STE 130",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330201937",
            "telephone_number": "954-925-3844",
            "fax_number": "954-925-3845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUCHEREAU",
        "first_name": "ANNIE",
        "name_prefix": "Mrs.",
        "credential": "MPTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-16",
        "last_updated": "2025-05-09",
        "certification_date": "2025-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT19446",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "886421700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2025; 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.