Individual provider Active NPI

Claire Esther Boutwell, PA-C

  • Physician Assistant
  • Charleston, WV
National Provider Identifier
1861291486
Registry record updated Mar 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
170 Silver Maple RDG Unit 2
Charleston, WV 25306-0106
Phone
(407) 484-4499
NPI assigned
Mar 8, 2025
Last updated
Mar 8, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU Primary

Addresses

Primary practice location

170 Silver Maple RDG Unit 2
Charleston, WV 25306-0106

Mailing address

170 Silver Maple RDG Unit 2
Charleston, WV 25306-0106

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20250729003532 FL Practitioner - Physician Assistant 6901313493 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4660 13TH St
Saint Cloud, FL 34769-6765
Phone (407) 200-2300

4757 The Grove Dr
Suite 132
Windermere, FL 34786-8426
Phone (407) 200-2300

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Adventist Health System Sunbelt, Inc Physician Assistant CurrentSince Jul 17, 2025 Accepting new patients
Adventist Health System/Sunbelt, Inc Physician Assistant CurrentSince Jul 17, 2025 Accepting new patients

Locations

2600 Westhall Ln
Ste 300
Maitland, FL 32751
Phone (407) 200-1353

4660 13th St
Saint Cloud, FL 34769
Phone (321) 805-4650

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1741392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741392000000",
    "number": "1861291486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 SILVER MAPLE RDG UNIT 2",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253060106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 SILVER MAPLE RDG UNIT 2",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253060106",
            "telephone_number": "407-484-4499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUTWELL",
        "first_name": "CLAIRE",
        "middle_name": "ESTHER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-08",
        "last_updated": "2025-03-08",
        "certification_date": "2025-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

Verify at the official NPI Registry.