DR. SUSAN B BOUTILIER (NPI# 1558368936) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558368936 |
| Entity Type | Individual |
| Full Name | DR. SUSAN B BOUTILIER |
| Credential | M.D. |
| Practice Address |
2280 Hemby Ln Greenville NC 27834-3773 |
| Mailing Address |
Po Box 751069 Charlotte NC 28275-1069 |
| Practice Telephone | 2527524848 |
| Practice Fax Number | 2527529607 |
| Enumeration Date | 2005-06-30 |
| Last Update Date | 2016-08-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0402X |
Psychiatry & Neurology Specialization: Neurology with Special Qualifications in Child Neurology |
9701256 | NC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 1558368936 | 05 | |
| NC | BCBSNC | 1122N | 01 |
| NC | RAILROAD MEDICARE | 370011207 | 01 |
| Street Address |
2280 HEMBY LN |
| City | GREENVILLE |
| State | NC |
| Zip Code | 27834-3773 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164827416 | Jenna Aldridge | Nurse Practitioner | 2280 Hemby Ln, Ecu Physicians Neurology, Greenville, NC 27834-3773 | 2014-10-29 |
| 1689019259 | Ecu Medicine Neurology Services | Neuromusculoskeletal Medicine & OMM | 2280 Hemby Ln, Greenville, NC 27834-3773 | 2013-05-08 |
| 1922347749 | Kristie Michelle Du Sablon | Physician Assistant | 2280 Hemby Ln, Ecu Physicians Neurology, Greenville, NC 27834-3773 | 2013-02-14 |
| 1629322987 | Bushra Javed | Psychiatry & Neurology | 2280 Hemby Ln, Greenville, NC 27834-3773 | 2012-11-07 |
| 1013212158 | Felicia R. Richardson | Nurse Practitioner | 2280 Hemby Ln, Ecu Physicians Neurology, Greenville, NC 27834-3773 | 2011-01-21 |
| 1669772539 | Jared Noroozi | Psychiatry & Neurology | 2280 Hemby Ln, Greenville, NC 27834-3773 | 2010-10-26 |
| 1477874618 | Jessica Danison | Psychiatry & Neurology | 2280 Hemby Ln, Greenville, NC 27834-3773 | 2010-06-22 |
| 1548582596 | East Carolina Neurology | Clinical Neuropsychologist | 2280 Hemby Ln, Greenville, NC 27834-3773 | 2010-02-18 |
| 1922330901 | Meagan A Holcomb | Nurse Practitioner | 2280 Hemby Ln, Ecu Physicians Neurology Services, Greenville, NC 27834-3773 | 2010-02-02 |
| 1114168358 | Frances Li Smith | Physician Assistant | 2280 Hemby Ln, Greenville, NC 27834-3773 | 2009-03-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841801255 | Nicholas Mcarthur Bennett | Day Training, Developmentally Disabled Services | 302 C, Greenville, NC 27834 | 2020-08-11 |
| 1275150245 | Shelby Renee Jones | Student in an Organized Health Care Education/Training Program | East Carolina University College of Nursing, 600 Moye Blvd, Greenville, NC 27834 | 2020-06-25 |
| 1194347138 | Soban Ahmad | Student in an Organized Health Care Education/Training Program | 600 Moye Blvd., Vmc Ma Room 350. Internal Medicine Resi, Mailstop #734, Greenville, NC 27834 | 2020-05-13 |
| 1427687789 | Brandon Allen Yates | Student in an Organized Health Care Education/Training Program | 435 Clinic Drive, Greenville, NC 27834 | 2020-04-07 |
| 1144854407 | Kristen Springer Dreyfus | Marriage & Family Therapist | 2609 West Arlington Blvd Suite 106, Greenville, NC 27834 | 2020-02-26 |
| 1861038606 | Southern Surgical Outpatient Surgery Center, Pa | Clinic/Center | 2457 Emerald Place, Greenville, NC 27834 | 2019-11-26 |
| 1003460569 | Shaun Fitzpatrick | Nurse Practitioner | Physicians East, Pa 1850 W. Arlington Blvd., Greenville, NC 27834 | 2019-08-01 |
| 1649831496 | Katherine Salome Ross | Genetic Counselor, MS | 524 Moye Blvd, Greenville, NC 27834 | 2019-06-24 |
| 1477011880 | Lauren Bethune Scroggs | Counselor | 2150 West 5th Street, Health Sciences Building Mailstop 688, Greenville, NC 27834 | 2019-03-05 |
| 1669998001 | Idella's Care Home | Community/Behavioral Health | 2912 Lee Ct # 9a, Greenville, NC 27834 | 2017-08-17 |
| Find all providers in zip 27834 | ||||
| Taxonomy Code | 2084N0402X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology with Special Qualifications in Child Neurology |
| A Child Neurologist specializes in neurology with special skills in diagnosis and treatment of neurologic disorders of the neonatal period, infancy, early childhood, and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376938936 | Adrienne B Bruce | Psychiatry & Neurology | 110 Jervey Rd, Greenville, SC 29609-1342 | 2015-03-31 |
| 1174561864 | Augusto Morales | Psychiatry & Neurology | 200 Patewood Dr Ste A350, Greenville, SC 29615-3547 | 2006-06-03 |
| 1427357219 | Sunjay Ryan Nunley | Psychiatry & Neurology | 200 Patewood Dr Ste A350, Greenville, SC 29615-3547 | 2011-03-20 |
| 1861710527 | Michael Arthur Babcock | Psychiatry & Neurology | 200 Patewood Dr, Suite A350, Greenville, SC 29615-3593 | 2010-05-05 |
| 1588759989 | Christine Marie Tangredi | Psychiatry & Neurology | 2280 Hemby Ln, Ecu Physicians Neurology, Greenville, NC 27834-3773 | 2006-10-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033675079 | Novant Medical Group Inc | Psychiatry & Neurology | 1918 Randolph Rd Ste 320, Charlotte, NC 28207-1109 | 2019-02-14 |
| 1740547496 | Dmitry Tchapyjnikov | Psychiatry & Neurology | Dept of Pediatrics Duke University Medical Ctr, 2301 Erwin Rd., Children's Health Center, Duke Universi, Durham, NC 27710-0001 | 2012-04-19 |
| 1043525280 | Cmc-northeast, Inc. | Psychiatry & Neurology | 6600 Wilkinson Blvd, Carolinas Pediatric Neurology Care - Holy Angels, Belmont, NC 28012-2796 | 2010-08-12 |
| 1750610689 | Virinder Nohria | Psychiatry & Neurology | 111 Skyline View Rd, Franklin, NC 28734-4769 | 2009-12-24 |
| 1144463993 | Monica Elizabeth Lemmon | Psychiatry & Neurology | Dumc 3936, Durham, NC 27710-6667 | 2009-04-09 |
| 1245431600 | Yael Shiloh-malawsky | Psychiatry & Neurology | 170 Manning Dr., Department of Neurology Cb#7025, Chapel Hill, NC 27514-4220 | 2007-05-31 |
| 1598795635 | Kadry R Allaboun | Psychiatry & Neurology | 115 Foothills Dr, Morganton, NC 28655-5152 | 2006-07-04 |
| 1962473033 | David Jay Jaffe | Psychiatry & Neurology | 508 Sandhurst Dr, A, Fayetteville, NC 28304-4434 | 2006-01-27 |
| 1164987616 | Novant Medical Group Inc | Psychiatry & Neurology | 311 Coddle Market Dr Nw, Ste 200, Concord, NC 28027-2432 | 2019-02-08 |
| 1437629664 | Mission Community Anesthesiology Specialists LLC | Psychiatry & Neurology | 890 Hendersonville Rd Ste 200, Asheville, NC 28803-2997 | 2018-11-30 |
| Find all providers with the same taxonomy | ||||
| City | GREENVILLE |
| Zip Code | 27834 |
Please comment or provide details below to improve the information on DR. SUSAN B BOUTILIER.
| 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.