Individual provider Active NPI

Amy L. Boughan, ANP

  • Adult Health Nurse Practitioner
  • Boston, MA
National Provider Identifier
1841381506
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
170873 Issued in MA
Practice address
45 Francis St
BWH Weiner Center
Boston, MA 02115-6105
Phone
(617) 732-5179
Fax
(617) 975-0885
NPI assigned
Sep 27, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 170873 MA Primary

Addresses

Primary practice location

45 Francis St
BWH Weiner Center
Boston, MA 02115-6105

Mailing address

40 Gatsby Dr
Unit # 7
Raynham, MA 02767-8075
Phone (508) 884-3440

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
170873MAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Brigham and Women's Hospital Current Accepting new patients

Interoperability endpoints

  • Direct secure messaging: boughan.amy.bwh@direct.partners.masshiway.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1841381506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 GATSBY DR",
            "address_2": "UNIT # 7",
            "city": "RAYNHAM",
            "state": "MA",
            "postal_code": "027678075",
            "telephone_number": "508-884-3440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 FRANCIS ST",
            "address_2": "BWH WEINER CENTER",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021156105",
            "telephone_number": "617-732-5179",
            "fax_number": "617-975-0885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUGHAN",
        "first_name": "AMY",
        "middle_name": "L.",
        "name_prefix": "Ms.",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MA",
            "license": "170873",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.