Nedrana Boutte, M.D.
Individual provider Active NPI Family Medicine Physician · Winnie, TX
NPI 1982805586 · NPPES record last updated Jan 5, 2010
Key facts
- NPI
- 1982805586
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- M6974 (TX)
- Practice address
- 538 Broadway
Winnie, TX 77665-7600 - Phone
- (409) 296-9505
- Fax
- (409) 296-2506
- NPI assigned
- May 30, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 14
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Thompson Outpatient Clinic, LLC
Practice addresses (Care Compare)
233 Spur
Suite 5
Winnie, TX 77665-7308
Phone (409) 296-2910
Hospital & facility affiliations
- Innovative Health Services Inc
- Centerwell Home Health
- Signature Health Services
- Accentcare Home Health of Texas
- Gentiva
- Heart to Heart Hospice of the Gulf Coast
- Riceland Medical Center
- Bayside Community Hospital
- Christus Southeast Texas- St Elizabeth
- Baptist Beaumont Hospital
- Houston Methodist Baytown Hospital
- Arboretum Nursing and Rehabilitation Center of Win
- Riceland Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20071210000668 | TX | Practitioner - Family Practice | 1850480054 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Boutte Family Practice, PLLC | Family Medicine | Current |
Accepting new patients |
| Thompson Outpatient Clinic, LLC | Family Medicine | Current |
Accepting new patients |
| Winnie Community Hospital, LLC | Past | Accepting new patients | |
| Chambers County | Past | Accepting new patients |
Locations
233 Spur 5
Winnie, TX 77665
Phone (409) 296-2910
304 Broadway
Winnie, TX 77665
Phone (409) 286-2910
538 Broadway
Winnie, TX 77665
Phone (409) 296-6000
Interoperability endpoints
- nboutte@wcrclnd.securechart.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | M6974 | TX | Yes |
Addresses
Primary practice location
538 Broadway
Winnie, TX 77665-7600
Mailing address
PO Box 714
Winnie, TX 77665-0714
Phone (409) 296-9505
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8S2464 | Other | TX | BCBS |
| 189110301 | Medicaid | TX |
Other providers in Winnie, TX
- Sharon L. Atwell
- Hilari Beth Berklund
- Kaci Blackshear
- Rebecca Louise Blackwell
- Boutte Family Practice, PLLC
- Dale Wayne Brock
- Brookshire Brothers Inc
- William Clay Brown
- Margaret Deanna Campbell
- Chambers County
All providers in Winnie, TX · Family Medicine Physician in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 5, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.