Mary Elizabeth Bouchard, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

028375-1 Issued in NY

Practice address

214 King Street
Ogdensburg, NY 13669

Phone

(315) 713-5660

Fax

(315) 393-0055

NPI assigned

Jan 21, 2019

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Claxton-Hepburn Medical Center

  • Psychiatric Hospital
  • Ogdensburg, NY
  • NPI 1891753034
  Medicare reassignment NPD
• Ogdensburg City School District

  • Nursing Care Agency
  • Ogdensburg, NY
  • NPI 1144598111
  NPD (past)
• Ogdensburg City School District

  • School Registered Nurse
  • Ogdensburg, NY
  • NPI 1407125248
  NPD (past)

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

{
    "created_epoch": "1548028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720569600000",
    "number": "1932673100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 KING STREET",
            "city": "OGDENSBURG",
            "state": "NY",
            "postal_code": "13669",
            "telephone_number": "315-713-5660",
            "fax_number": "315-393-0055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 KING STREET",
            "city": "OGDENSBURG",
            "state": "NY",
            "postal_code": "13669",
            "telephone_number": "315-713-5660",
            "fax_number": "315-393-0055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUCHARD",
        "first_name": "MARY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-21",
        "last_updated": "2024-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "028375-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05509600",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ernesto Avi Bonaparte, D.D.S
• David Mark Bookman
• Chidi Emeka Boston, FNP
• Jeffrey Robert Bouchard, RPH
• Julie Bouchard
• Lesley Anne Bouchey, LPN
• Sondra Jean Bouchey, LPN
• Jade Marie Boyer
• Susan Boyer
• Alyssa Brabant, RN

• Speech-Language Pathologist in Ogdensburg, NY
• Providers in Ogdensburg, NY by specialty
• Speech-Language Pathologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.