Deambra Lea Boucher, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2006016870 Issued in MO

Practice address

13900 E US Highway 40 Ste a
Independence, MO 64055-5877

Phone

(816) 478-0500

NPI assigned

Oct 16, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• America's Best Contacts and Eyeglasses, Inc.

  • Eyewear Supplier
  • Independence, MO
  • NPI 1669404174
  NPD (past)

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972683746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1644 NW GARRETT",
            "city": "BLUE SPRINGS",
            "state": "MO",
            "postal_code": "64015",
            "telephone_number": "316-641-4219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13900 E US HIGHWAY 40 STE A",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640555877",
            "telephone_number": "816-478-0500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUCHER",
        "first_name": "DEAMBRA",
        "middle_name": "LEA",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2006016870",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KS",
            "license": "1712",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shelby Boos, LPN
• Gary Allen Boring, DC
• Michelle Borr
• Robert Ryan Borsheski, D.O.
• Tonishia Boston
• Margaret Boucher
• Jeremy Lee Bowen, D.D.S.
• Johnathan Michael Bowen, DPT
• Dylan Timothy Bowling, PTA
• Donnie Ray Bowman Jr., PHARMD

• Optometrist in Independence, MO
• Providers in Independence, MO by specialty
• Optometrist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.