Stephanie Bouchard, DO

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

250 Park St
Bowling Green, KY 42101-1760

Phone

(270) 745-1000

NPI assigned

Mar 26, 2024

Last updated

Mar 26, 2024By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in KY

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 Osteopathy

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

{
    "created_epoch": "1711411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711411200000",
    "number": "1811747231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19519 GULF BLVD UNIT 405",
            "city": "INDIAN SHORES",
            "state": "FL",
            "postal_code": "337852206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 PARK ST",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421011760",
            "telephone_number": "270-745-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUCHARD",
        "first_name": "STEPHANIE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-26",
        "last_updated": "2024-03-26",
        "certification_date": "2024-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samuel Booth, M.S. CCC-SLP
• Will Patrick Boothe
• Matthew Boshears, RBT
• Emily Boston, CSW
• Morgan Ashley Bottoms
• Rene Albert Boucher, DO
• Kimberly Dawn Bowen, PT
• Bowling Green Anesthesiology Associates, PSC
• Bowling Green Dermatology & Skin Cancer Specialists PLLC
• Bowling Green Dialysis Center Inc

• Student in an Organized Health Care Education/Training Program in Bowling Green, KY
• Providers in Bowling Green, KY by specialty
• Student in an Organized Health Care Education/Training Program in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2024; 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.