Courtney Leigh Boucke, N.P.

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

20879 Issued in CA

Practice address

300 Sierra College Dr Ste 105
Grass Valley, CA 95945-5084

Phone

(530) 273-3377

Fax

(530) 273-3387

NPI assigned

Nov 26, 2012

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 CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dignity Health Medical FoundationGroup PAC ID 7810800661, 1,211 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sierra Nevada Memorial Hospital Hospital, Grass Valley, CA, CCN 050150

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Dignity Health Medical Foundation

  • Multi-Specialty Clinic/Center
  • Sacramento, CA
  • NPI 1700803418
  Medicare reassignment Care Compare group NPD
• Dignity Health Medical Foundation

  • Multi-Specialty Clinic/Center
  • Redding, CA
  • NPI 1912288432
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Sierra Nevada Memorial-Miners Hospital

  • General Acute Care Hospital
  • Grass Valley, CA
  • NPI 1659361392
  Care Compare affiliation

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

{
    "created_epoch": "1353888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729036800000",
    "number": "1831433119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 SIERRA COLLEGE DR STE 105",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959455084",
            "telephone_number": "530-273-3377",
            "fax_number": "530-273-3387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 SIERRA COLLEGE DR STE 105",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959455084",
            "telephone_number": "530-273-3377",
            "fax_number": "530-273-3387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUCKE",
        "first_name": "COURTNEY",
        "middle_name": "LEIGH",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-26",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "20879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tomas Borsky
• Carianne Boucher, OTR/L
• Jessica Boucher
• Bouchier-Pritchett Family Medicine PC
• Todd Bouchier, MD
• Leann Boutte
• Lauren Ellie Bowman Wulf
• Vera Boyko, PT, DPT
• Thomas Michael Boyle, MD
• Kathleen Brady, D.C.

• Adult Health Nurse Practitioner in Grass Valley, CA
• Providers in Grass Valley, CA by specialty
• Adult Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.