Bethany Marie Boulger

Key facts

NPI

1952632895

Entity type

Individual (NPI type 1)

Primary specialty

Massage Therapist 225700000X

Practice address

532 Main St
Suite 2
Bennington, VT 05201-2875

Phone

(802) 447-2900

NPI assigned

Jan 15, 2010

Sex

Female

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jan 15, 2010.

{
    "created_epoch": "1263513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263513600000",
    "number": "1952632895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 HOUGHTON LN",
            "city": "BENNINGTON",
            "state": "VT",
            "postal_code": "052018092",
            "telephone_number": "413-663-4585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "532 MAIN ST",
            "address_2": "SUITE 2",
            "city": "BENNINGTON",
            "state": "VT",
            "postal_code": "052012875",
            "telephone_number": "802-447-2900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOULGER",
        "first_name": "BETHANY",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-15",
        "last_updated": "2010-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Bennington, VT · Massage Therapist in Vermont