Rebekah Elisabeth-Carradine Boulanger

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

04785 Issued in KY

Practice address

1234 Napier Ave
Saint Joseph, MI 49085-2112

Phone

(269) 983-8300

NPI assigned

Apr 21, 2017

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 names 1

• Rebekah Elisabeth-Carradine Boulanger Professional name

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal Medicine

Education

Touro Un College of Osteopathic Medicine, Vallejo, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cogent Healthcare of Kentucky, PSCGroup PAC ID 0648294157, 106 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Saint Joseph London Hospital, London, KY, CCN 180011

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rboulanger289343@direct.stlukeshealth.org

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.

• Cogent Healthcare of Kentucky, PSC

  • Internal Medicine Physician
  • Lexington, KY
  • NPI 1053362293
  Medicare reassignment Care Compare group NPD
• Hospitalist Medicine Physicians of Indiana, LLC

  • Internal Medicine Physician
  • Brentwood, TN
  • NPI 1720416555
  NPD
• Saint Joseph Health System, Inc

  • Rural Acute Care Hospital
  • London, KY
  • NPI 1992701429
  NPD (past)

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

• Saint Joseph Health System, Inc

  • Rural Acute Care Hospital
  • London, KY
  • NPI 1992701429
  Care Compare affiliation

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

{
    "created_epoch": "1492732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600387200000",
    "number": "1942735477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1234 NAPIER AVE",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490852112",
            "telephone_number": "269-983-8300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1234 NAPIER AVE",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490852112",
            "telephone_number": "269-983-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOULANGER",
        "first_name": "REBEKAH",
        "middle_name": "ELISABETH-CARRADINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-21",
        "last_updated": "2020-09-18",
        "certification_date": "2020-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "04785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBEKAH",
            "last_name": "BOULANGER",
            "middle_name": "ELISABETH-CARRADINE",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Jay Richard Bond
• Blanka Bono
• Eva M Borcherding, LMT
• Frederick William Born, D.O.
• Daniel Davis Bosis Jr., M.D.
• James Daniel Bozyk II, PA
• Michelle E Branch, CMA
• Daniel W Brash, M.D.
• Kelly M Brash, MD
• Julie M. Brawer, CNP

• Internal Medicine Physician in Saint Joseph, MI
• Providers in Saint Joseph, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.