MR. JASON GLENN BOUTWELL (NPI# 1184281982) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184281982 |
| Entity Type | Individual |
| Full Name | MR. JASON GLENN BOUTWELL |
| Credential | APRN |
| Practice Address |
7120 Caraway Ln Southport FL 32409-1605 |
| Practice Telephone | 8508145547 |
| Mailing Telephone | 8508145547 |
| Enumeration Date | 2019-05-28 |
| Last Update Date | 2019-05-28 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
APRN11002476 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144224478 | Jason G Boutwell | Dentist | 3009 Chapel Hill Rd, Suite A, Douglasville, GA 30135-1748 | 2005-06-01 |
| Street Address |
7120 CARAWAY LN |
| City | SOUTHPORT |
| State | FL |
| Zip Code | 32409-1605 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821278102 | Brenda Louise Rosas | Speech-Language Pathologist | 12801 Merial Pass, Panama City, FL 32409 | 2007-11-05 |
| 1619416880 | Med-trans Corporation | Ambulance | 550 Highway 2300, Southport, FL 32409-1293 | 2017-02-21 |
| 1588170534 | Regina M Mcmillin | Assistant Behavior Analyst | 9315 Sandra Grace Rd, Southport, FL 32409-1834 | 2017-12-28 |
| 1811154784 | Regina A Shirley | Nurse's Aide | 8822 Jeffery Rd, Southport, FL 32409-1885 | 2008-05-19 |
| 1114553328 | Michele Lee Zelaya | Registered Nurse | 11830 Raccoon Rd, Panama City, FL 32409-2304 | 2020-03-19 |
| 1306499629 | Lisha Myranda Estes | Massage Therapist | 1829 Edwards Rd, Southport, FL 32409-2403 | 2019-07-17 |
| 1760572432 | Cheryl G. Fitzgerald | Social Worker | 14240 Sand Pine Ln, Panama City, FL 32409-2559 | 2006-10-13 |
| 1427269836 | Kathryn Mcgrath | Counselor | 13117 White Western Springs Rd, Southport, FL 32409-3557 | 2007-05-25 |
| 1215574025 | Nadine Sue Pearish | Nurse Practitioner | 1906 Anna Lauren Dr, Southport, FL 32409-3567 | 2019-12-01 |
| 1659716652 | Kelsi Jean Vinson | Specialist/Technologist, Other | 7318 Mary Jo Ave, Panama City, FL 32409-4162 | 2013-05-03 |
| Find all providers in zip 32409 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215574025 | Nadine Sue Pearish | Nurse Practitioner | 1906 Anna Lauren Dr, Southport, FL 32409-3567 | 2019-12-01 |
| 1649736653 | Sherrie Gray Cass | Nurse Practitioner | 3960 Executive Park Blvd Ste 600, Southport, NC 28461-8185 | 2019-02-14 |
| 1245552595 | Dora Connelly Loflin | Nurse Practitioner | 4705 Southport Supply Rd Se, Southport, NC 28461-9074 | 2010-02-26 |
| 1861956104 | Kristin Elizabeth Johnston | Nurse Practitioner | 4734 Long Beach Rd Se, Southport, NC 28461-8721 | 2019-01-30 |
| 1194266023 | Amanda Dewitt Reynolds | Nurse Practitioner | 4222 Long Beach Rd Se, Southport, NC 28461-8627 | 2017-03-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710588413 | Arnol Miguel Chacon Chacon | Nurse Practitioner | 1001 Rich Dr, Palm Springs, FL 33406-6508 | 2020-11-08 |
| 1427659192 | Monica Teresita Vengoechea Leon | Nurse Practitioner | 68 Se 6th St Apt 4104, Miami, FL 33131-3519 | 2020-11-08 |
| 1740881416 | Donald Douglass Jamieson | Nurse Practitioner | 17929 Hunting Bow Cir # Na, Lutz, FL 33558-5378 | 2020-11-08 |
| 1609477348 | Danielle Schmidt | Nurse Practitioner | 7803 34th Ct E, Sarasota, FL 34243-2867 | 2020-11-07 |
| 1083215735 | Ahecio Alexander Labrada Izquierdo | Nurse Practitioner | 624 Sw 132nd Ter, Davie, FL 33325-3242 | 2020-11-07 |
| 1114528874 | Wandering Michelle, LLC | Nurse Practitioner | 526 Wekiva Bluff St, Apopka, FL 32712-2776 | 2020-11-07 |
| 1508467325 | Digna Maria Espinosa | Nurse Practitioner | 13655 Sw 2nd St, Miami, FL 33184-1049 | 2020-11-06 |
| 1265033005 | Lourdes Milagros Rivera | Nurse Practitioner | 4512 Raintree Ridge Rd, Orlando, FL 32837-5133 | 2020-11-06 |
| 1023619913 | Ana Maria Guerra Garcia | Nurse Practitioner | 802 Windsor Cir, Brandon, FL 33510-2927 | 2020-11-05 |
| 1891396818 | Gilberto Fernandez Sr. | Nurse Practitioner | 8021 Nw 166th St, Miami Lakes, FL 33016-3421 | 2020-11-05 |
| Find all providers with the same taxonomy | ||||
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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.