NPIMap

Individual provider Active NPI

Brittany Lee Bouchard, DNP, FNP-C

  • Family Nurse Practitioner
  • SLC, UT
National Provider Identifier
1922601046
Registry record updated Mar 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
8315613-4405 Issued in UT
Practice address
450 S 900 E Ste 175
SLC, UT 84102-2981
Phone
(801) 456-2333
NPI assigned
Nov 20, 2020
Last updated
Mar 29, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 8315613-4405 UT Primary

Addresses

Primary practice location

450 S 900 E Ste 175
SLC, UT 84102-2981

Mailing address

801 E Silver Sage Dr
Sandy, UT 84094-4919

Electronic endpoints 2

TypeEndpointUseAffiliation
Other URL bbouchard@mobilenpcare.com Direct
Direct Messaging Address BBOUCHARD549779@DIRECT.MED.UTAH.EDU Direct University of Utah

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201221000436 UT Practitioner - Nurse Practitioner 1355753138 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of Utah Adult ServicesGroup PAC ID 0941525273, 1,758 clinicians

Practice addresses (Care Compare)

Sandy, UT 84094
Phone (801) 450-6081

1950 Circle of Hope Dr
Salt Lake City, UT 84112-5500
Phone (801) 585-2626

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.77 of 100Reported as group
Quality
91.47
Promoting interoperability
100
Improvement activities
40
Cost
74.42

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
8315613-4405UTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Utah Adult Services Current Accepting new patients
University of Utah Adult Services CurrentSince Dec 23, 2021 Accepting new patients
Above and Beyond Mobile Healthcare PC CurrentSince Oct 28, 2022 Accepting new patients
University of Utah Adult Services CurrentSince Dec 23, 2021 Accepting new patients

Locations

1950 Circle of Hope Dr
Slc, UT 84112
Phone (801) 585-0100

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

Organizations & group practices 4

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 3

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": "1605830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648512000000",
    "number": "1922601046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 E SILVER SAGE DR",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840944919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 S 900 E STE 175",
            "city": "SLC",
            "state": "UT",
            "postal_code": "841022981",
            "telephone_number": "801-456-2333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUCHARD",
        "first_name": "BRITTANY",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "DNP, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-20",
        "last_updated": "2022-03-29",
        "certification_date": "2022-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "8315613-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "bbouchard@mobilenpcare.com",
            "affiliation": "N",
            "endpointDescription": "Work email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "450 S 900 E Ste 175",
            "city": "Slc",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841022981",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "BBOUCHARD549779@DIRECT.MED.UTAH.EDU",
            "affiliation": "Y",
            "affiliationName": "University of Utah",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in SLC, UT

Sources for this page

Verify at the official NPI Registry.