Active NPI
Beverley L Bouchard, CPM, LM
- Midwife
- Fredericksburg, VA
National Provider Identifier
1841602299
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Midwife
- License
- CPM22050016
- Practice address
- 1003 Mahone St
Fredericksburg, VA 22401-6214 - Phone
- (540) 318-0055
- NPI assigned
- May 20, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Midwife | 176B00000X | PENDING | VA | |
| Doula | 374J00000X | |||
| Midwife | 176B00000X | CPM22050016 | VA | Primary |
Addresses
Primary practice location
1003 Mahone St
Fredericksburg, VA 22401-6214
Mailing address
6800 Hanover CT
Fredericksburg, VA 22407-6209
Phone (540) 688-9100
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0129000176 | Other | VA | VIRGINIA DEPARTMENT OF HEALTH PROFESSIONALS |
| 99499 | Other | VA | CPT |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | www.treeoflifefredericksburg.com |
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
| License | State | Type | Specialty |
|---|---|---|---|
| CPM22050016 | VA | MD | Midwife |
| PENDING | VA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1400544000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1667174400000",
"number": "1841602299",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6800 HANOVER CT",
"city": "FREDERICKSBURG",
"state": "VA",
"postal_code": "224076209",
"telephone_number": "540-688-9100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1003 MAHONE ST",
"city": "FREDERICKSBURG",
"state": "VA",
"postal_code": "224016214",
"telephone_number": "540-318-0055"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOUCHARD",
"first_name": "BEVERLEY",
"middle_name": "L",
"name_prefix": "Mrs.",
"credential": "CPM, LM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-05-20",
"last_updated": "2022-10-31",
"certification_date": "2022-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "176B00000X",
"taxonomy_group": "",
"desc": "Midwife",
"state": "VA",
"license": "PENDING",
"primary": false
},
{
"code": "374J00000X",
"taxonomy_group": "",
"desc": "Doula",
"state": null,
"license": null,
"primary": false
},
{
"code": "176B00000X",
"taxonomy_group": "",
"desc": "Midwife",
"state": "VA",
"license": "CPM22050016",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VIRGINIA DEPARTMENT OF HEALTH PROFESSIONALS",
"identifier": "0129000176",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CPT",
"identifier": "99499",
"state": "VA"
}
],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "www.treeoflifefredericksburg.com",
"affiliation": "N",
"address_1": "1003 Mahone St",
"city": "Fredericksburg",
"state": "VA",
"country_code": "US",
"postal_code": "224016214",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Fredericksburg, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.