JEREMY MICHAEL BOUCHER (NPI# 1093853053) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093853053 |
| Entity Type | Individual |
| Full Name | JEREMY MICHAEL BOUCHER |
| Credential | MD |
| Practice Address |
4131 Nw 122nd St Oklahoma City OK 73120-8869 |
| Mailing Address |
Dept 96-0480 Oklahoma City OK 73196-0480 |
| Practice Telephone | 4057759350 |
| Practice Fax Number | 4057759360 |
| Mailing Telephone | 4057759350 |
| Mailing Fax Number | 4057759360 |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2013-09-17 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207L00000X | Anesthesiology | 23387 | OK | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 20076550A | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366097115 | Jeremy M Boucher | Behavior Technician | 290 W Exchange Street, Suite 101, Providence, RI 02903 | 2019-08-08 |
| Street Address |
4131 NW 122ND ST |
| City | OKLAHOMA CITY |
| State | OK |
| Zip Code | 73120-8869 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245228857 | Stephen B. Rhodes, Md., Inc | Anesthesiology | 4131 Nw 122nd St, Oklahoma City, OK 73120-8869 | 2005-10-07 |
| 1760920615 | Brad A. Starkey Md PC | Anesthesiology | 4131 Nw 122nd St, Oklahoma City, OK 73120-8869 | 2017-02-10 |
| 1437602117 | Jennifer Bradford Md Pllc | Anesthesiology | 4131 Nw 122nd St, Oklahoma City, OK 73120-8869 | 2016-07-28 |
| 1225581903 | Premier Anesthesia Inc | Anesthesiology | 4131 Nw 122nd St, Oklahoma City, OK 73120-8869 | 2016-07-28 |
| 1033592993 | Jch, Md Pllc | Anesthesiology | 4131 Nw 122nd St, Oklahoma City, OK 73120-8869 | 2015-07-09 |
| 1437560513 | Kathryne Cates Md Pllc | Anesthesiology | 4131 Nw 122nd St, Oklahoma City, OK 73120-8869 | 2014-05-12 |
| 1891123600 | October Tuesday Corp | Anesthesiology | 4131 Nw 122nd St, Oklahoma City, OK 73120-8869 | 2013-10-15 |
| 1164760013 | Scott W Groves | Counselor | 4131 Nw 122nd St, Oklahoma City, OK 73120-8869 | 2013-01-28 |
| 1619213816 | Ascension Anesthesia, Pllc | Anesthesiology | 4131 Nw 122nd St, Oklahoma City, OK 73120-8869 | 2012-12-17 |
| 1215291877 | Sleepstat, LLC | Clinic/Center | 4131 Nw 122nd St, Oklahoma City, OK 73120-8869 | 2012-06-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134768971 | Nuvail Medical Services Inc | In Home Supportive Care | 3140 West Britton Road, Suite A, Oklahoma City, OK 73120 | 2019-12-26 |
| 1134781677 | Peak Solutions, LLC | Clinic/Center | 12401 Trail Oaks Drive, Therapy Room, 2nd Floor, Oklahoma City, OK 73120 | 2019-07-05 |
| 1992363881 | Laura Lynn's Home Care, LLC | Home Health | 9801 N May Ave, Oklahoma City, OK 73120 | 2019-06-05 |
| 1962992115 | Erin Lyn Florer | Occupational Therapist | 12401 Trail Oak Dr, Oklahoma City, OK 73120 | 2018-05-14 |
| 1780171009 | Diabetic Foot and Wound Center of Okfas | Podiatrist | 11100 Hefner Pointe Drive, Suite A, Oklahoma City, OK 73120 | 2018-04-23 |
| 1285134387 | Motley Vision Professionals, Pllc | Eyewear Supplier (Equipment, not the service) | 9805 N. May Avenue, Oklahoma City, OK 73120 | 2018-02-15 |
| 1043729700 | Jenna Marie Howard | Social Worker | 3301 North Meridian Ave., Building 100, Oklahoma City, OK 73120 | 2017-09-26 |
| 1962928895 | Susan Chacko | Counselor | 12000 N Virginia Avenue, Oklahoma City, OK 73120 | 2017-08-22 |
| 1023533262 | Farris Ree Stroupe | Audiologist | 4140 W. Memorial Rd Suite 116, Oklahoma City, OK 73120 | 2017-08-09 |
| 1881116200 | Rebekah Danielle Kabariti | Counselor | 12000 N. Virgnia Ave, Oklahoma City, OK 73120 | 2017-07-07 |
| Find all providers in zip 73120 | ||||
| Taxonomy Code | 207L00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Anesthesiology |
| An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an operation or an obstetric or diagnostic procedure. The anesthesiologist assesses the risk of the patient undergoing surgery and optimizes the patient's condition prior to, during and after surgery. In addition to these management responsibilities, the anesthesiologist provides medical management and consultation in pain management and critical care medicine. Anesthesiologists diagnose and treat acute, long-standing and cancer pain problems; diagnose and treat patients with critical illnesses or severe injuries; direct resuscitation in the care of patients with cardiac or respiratory emergencies, including the need for artificial ventilation; and supervise post-anesthesia recovery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417463548 | Integrated Anesthesia Services, Pllc | Anesthesiology | 5030 N May # 291, Oklahoma City, OK 73112-6010 | 2017-12-27 |
| 1942710066 | Christopher C. Shadid, Md, Pllc | Anesthesiology | 837 Nw 41st St, Oklahoma City, OK 73118-6822 | 2017-10-03 |
| 1699124297 | Sterling Etim Euk Udom | Anesthesiology | 750 Ne 13th, Suite 200, College of Medicine, Oklahoma City, OK 73104 | 2016-06-06 |
| 1710331079 | Joseph Mosley | Anesthesiology | 750 Ne 13th Oac 200, Oklahoma City, OK 73104 | 2016-04-22 |
| 1639570427 | Rrm Medical Pllc | Anesthesiology | 3048 Sw 89th St Ste A, Oklahoma City, OK 73159-6359 | 2014-09-11 |
| 1962763110 | Sheila Busch Campbell | Anesthesiology | 3532 Quail Creek Rd, Oklahoma City, OK 73120-8911 | 2012-06-05 |
| 1497012272 | Neda Sadeghi | Anesthesiology | 12016 Dahoon Dr, Oklahoma City, OK 73120-8131 | 2012-04-18 |
| 1861760837 | John Bernard Gilleran | Anesthesiology | 4940 Nw 31st St, Oklahoma City, OK 73122 | 2011-12-06 |
| 1609161231 | Ksenia Koltun | Anesthesiology | 13321 N. Meridian Suite 402, Oklahoma City, OK 73120 | 2011-06-11 |
| 1861722357 | Anesthesia and Tee Services, PC | Anesthesiology | 149 Lake Aluma Dr, Oklahoma City, OK 73121-3401 | 2010-01-05 |
| Find all providers in OKLAHOMA CITY | ||||
| City | OKLAHOMA CITY |
| Zip Code | 73120 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.