JOSHUA D BOUCHER (NPI# 1316390990) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316390990 |
| Entity Type | Individual |
| Full Name | JOSHUA D BOUCHER |
| Credential | DO |
| Practice Address |
300 East Hospital Rd Fort Gordon GA 30905-5650 |
| Mailing Address |
300 West Hospital Rd Fort Gordon GA 30905-5650 |
| Practice Telephone | 7067871648 |
| Practice Fax Number | 7067871745 |
| Mailing Telephone | 7067871648 |
| Mailing Fax Number | 7067877201 |
| Enumeration Date | 2016-07-19 |
| Last Update Date | 2017-09-26 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 02005183A | IN | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134209901 | Joshua P Boucher | Optometrist | 4027 Mill St, Kansas City, MO 64111-3008 | 2006-10-16 |
| Street Address |
300 EAST HOSPITAL RD |
| City | FORT GORDON |
| State | GA |
| Zip Code | 30905-5650 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063412500 | Virginia Yates | Family Medicine | 300 East Hospital Rd, Credentials Coordinator, Fort Gordon, GA 30905 | 2005-07-27 |
| 1821640756 | Jackie Nancy Chung | Student in an Organized Health Care Education/Training Program | 300 East Hospital Rd, Fort Gordon, GA 30905-5650 | 2019-07-11 |
| 1821524802 | Joshua Keith Hattaway | Orthopaedic Surgery | 300 East Hospital Rd, Fort Gordon, GA 30905-5650 | 2017-05-11 |
| 1730635442 | Caitlin Christoffel | Student in an Organized Health Care Education/Training Program | 300 East Hospital Rd, Fort Gordon, GA 30905-5650 | 2016-09-01 |
| 1598147068 | Erin Caddell | Student in an Organized Health Care Education/Training Program | 300 East Hospital Rd, General Surgery Program, Ddeamc, Fort Gordon, GA 30905-5650 | 2015-06-22 |
| 1861874547 | Matthew Schorr IIi | Student in an Organized Health Care Education/Training Program | 300 East Hospital Rd, Fort Gordon, GA 30905 | 2015-06-18 |
| 1578978052 | Alicia Evans | Student in an Organized Health Care Education/Training Program | 300 East Hospital Rd, Family Medicine, Dwight D Eisenhower Army Medical Cente, Fort Gordon, GA 30905-5650 | 2014-06-24 |
| 1306274154 | Leslie Walker Roberson | Psychologist | 300 East Hospital Rd, Fort Gordon, GA 30905-5741 | 2013-10-14 |
| 1487975983 | Meredith Hays | Internal Medicine | 300 East Hospital Rd, Fort Gordon, GA 30905-5650 | 2010-06-18 |
| 1427378884 | Roy Guinto Jr. | Internal Medicine | 300 East Hospital Rd, D.d. Eisenhower Army Medical Center, Fort Gordon, GA 30905 | 2010-06-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417508995 | Priscilla Denise Brown | Prosthetic/Orthotic Supplier | 38200 3rd Ave, Fort Gordon, GA 30905 | 2019-09-25 |
| 1740754308 | Patricia Lynn Blevins | Nurse Practitioner | 300 E Hospital Dr, Augusta, GA 30905 | 2019-01-17 |
| 1861971335 | Isabella Anderson | Dentist | Usa Dental Activity, Hospital Dental Clinic, Bldg 38801 Academic, Ste B&c, Ft Gordon, GA 30905 | 2018-08-07 |
| 1972097426 | Cortney Wolfley | Student in an Organized Health Care Education/Training Program | Orthopaedics Ddeamc, 300 East Hospital Road, Fort Gordon, GA 30905 | 2018-06-19 |
| 1003337536 | David Jonathon Sabovich | Dentist | 38801 Academic Dr Ste B&cactivity, Suite B & C, Ft Gordon, GA 30905 | 2017-07-06 |
| 1437689411 | Marcos Aranda | Student in an Organized Health Care Education/Training Program | General Surgery, Eisenhower Army Medical Center, 300 East Hospital Road, Fort Gordon, GA 30905 | 2017-06-13 |
| 1659809846 | Brian Kevin Burke | Student in an Organized Health Care Education/Training Program | 300 East Hosptial Road, Fort Gordon, GA 30905 | 2017-06-01 |
| 1902334469 | Jacqueline Renee Mulhall | Student in an Organized Health Care Education/Training Program | Ddeamc, 300 E Hospital Rd, General Surgery, Fort Gordon, GA 30905 | 2017-05-30 |
| 1750837456 | Amanda R Bailey | Internal Medicine | 300 E. Hospital Dr., Fort Gordon, GA 30905 | 2016-09-01 |
| 1689120016 | Thomas S Moffitt | Internal Medicine | Im, Dwight D Eisenhower Army Medical Center, 300 East Hospital Road, Fort Gordon, GA 30905 | 2016-08-26 |
| Find all providers in zip 30905 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003290511 | Daniel Jason Frasca | Family Medicine | 300 E. Hospital Rd., Fort Gordon, GA 30905 | 2015-07-14 |
| 1902206907 | Elizabeth Ashley Suniega | Family Medicine | Connelly Health Clinic, Building 29709, B Street, Fort Gordon, GA 30905 | 2014-08-26 |
| 1073778866 | Amayi Maria Bloodsaw | Family Medicine | 301 East Hospital Road, Fort Gordon, GA 30905-5650 | 2008-07-22 |
| 1730177965 | Jason Seton Lanham | Family Medicine | 300 Hospital Drive, Family Medicine Clinic, Fort Gordon, GA 30905-5650 | 2005-10-12 |
| 1881695328 | Carolynn Marie Warner | Family Medicine | 300 East Hospital Drive, Ddeamc, Virtual Health, Fort Gordon, GA 30905 | 2005-08-09 |
| 1063412500 | Virginia Yates | Family Medicine | 300 East Hospital Rd, Credentials Coordinator, Fort Gordon, GA 30905 | 2005-07-27 |
| 1275535593 | Thomas Philip Garigan Jr. | Family Medicine | Bldg 300 East Hospital Road, Ddeamc (attn: Dfcm-fmc), Fort Gordon, GA 30905-3851 | 2005-06-01 |
| 1902323538 | Jameika Crawford-dicks | Family Medicine | 300 W Hospital Rd, Fort Gordon, GA 30905-5741 | 2017-08-24 |
| 1841727047 | Michal Poplawski | Family Medicine | 300 W Hospital Rd, Fort Gordon, GA 30905-5741 | 2017-05-18 |
| 1053847178 | Anthony Bieck | Family Medicine | 300 East Hospital Road, Dwight David Eisenhower Army Medical Center, Fort Gordon, GA 30905-5650 | 2017-05-10 |
| Find all providers in FORT GORDON | ||||
| City | FORT GORDON |
| Zip Code | 30905 |
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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.