Paul R Bouchillon, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT0953 Issued in MS

Practice address

65 Dutch LN
Columbus, MS 39702-5523

Phone

(662) 327-6705

Fax

(662) 327-6760

NPI assigned

May 3, 2006

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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.

• Triumph Physical Therapy Limited Partnership

  • Physical Therapist
  • Tupelo, MS
  • NPI 1508804261
  NPD (past)

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357084800000",
    "number": "1821056326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 DUTCH LN",
            "city": "COLUMBUS",
            "state": "MS",
            "postal_code": "397025523",
            "telephone_number": "662-327-6705",
            "fax_number": "662-327-6760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 DUTCH LN",
            "city": "COLUMBUS",
            "state": "MS",
            "postal_code": "397025523",
            "telephone_number": "662-327-6705",
            "fax_number": "662-327-6760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUCHILLON",
        "first_name": "PAUL",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-03",
        "last_updated": "2013-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "PT0953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Will Allen Bonner, PHARMD
• William C Bonner, RPH
• Amber Massey Borden, MD
• Robert C. Borden, M.D.
• John Covington Boswell, M.D.
• Alexandra L Bourcy-Crandell, PA-C
• Brittany Lee Bowen, FNP-BC
• Jazmann Bowen
• Karissa Wright Boyd, DO
• Kenneth Brian Boyd, D.O.

• Physical Therapist in Columbus, MS
• Providers in Columbus, MS by specialty
• Physical Therapist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2013; 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.