Kelly K Boucher (NPI# 1528476207, PAC ID# 1456571017) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is OPTOMETRY.
| Nation Provider ID (NPI) | 1528476207 |
| PAC ID by PECOS | 1456571017 |
| Professional Enrollment ID | I20141001002687 |
| Full Name | Kelly K Boucher |
| Organization Legal Name | CHOCTAW NATION OF OKLAHOMA |
| Address |
109 Kerr Blvd Poteau OK 74953-5231 |
| Phone Number | 9185677000 |
| Gender | F |
| Medical School | INDIANA UNIVERSITY - SCHOOL OF OPTOMETRY |
| Graduation Year | 2014 |
| Primary Specialty | OPTOMETRY |
| Group Practice PAC ID | 1759294838 |
| Number of Group Practice Members | 174 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 370172 | CHOCTAW NATION HEALTH SERVICES AUTHORITY |
| 370171 | CHEROKEE NATION W W HASTINGS INDIAN HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 109 Kerr Blvd, Poteau, OK 74953-5231 | 9185677000 | CHOCTAW NATION OF OKLAHOMA |
| 301 S J T Stites St, Sallisaw, OK 74955-9302 | 9187759150 | CHEROKEE NATION |
| Organization Legal Name | CHOCTAW NATION OF OKLAHOMA |
| Physicians | 161 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Casey Woolsey | Nurse Practitioner | Choctaw Nation of Oklahoma | 902 Lincoln Rd, Choctaw National Health Care Idabel, Idabel, OK 74745-7817 |
| Darci Bowen | Nurse Practitioner | Choctaw Nation of Oklahoma | 1801 Chukkahina, Durant, OK 74701-7117 |
| Jennifer Michelle Parker | Nurse Practitioner | Choctaw Nation of Oklahoma | 2204 E Main Str, Choctaw Nation Health Care Stigler, Stigler, OK 74462-2822 |
| Jaclyn D Rouse | Optometry | Choctaw Nation of Oklahoma | 410 N M St, Choctaw Nation Health Care Hugo, Hugo, OK 74743-1820 |
| Jessica L Hall | Physician Assistant | Choctaw Nation of Oklahoma | 205 Dallas St, Talihina, OK 74571-2402 |
| Jonathan A Doyle | Psychiatry | Choctaw Nation of Oklahoma | 1127 S George Nigh Expy, Choctaw Nation Health Care Mcalester, Mcalester, OK 74501-7143 |
| Teresa G Tucker | Nurse Practitioner | Choctaw Nation of Oklahoma | 1300 E Martin Luther King Dr, Broken Bow, OK 74728-4160 |
| Michael S. Krischer | Podiatry | Choctaw Nation of Oklahoma | 1201 W Liberty Rd, Choctaw Nation Health Care Atoka, Atoka, OK 74525-1639 |
| Charles T Whittenburg | Orthopedic Surgery | Choctaw Nation of Oklahoma | 698 Westside Dr, 106 Choctaw Nation Health Aging, Durant, OK 74701-3085 |
| Shiela D Riley | Nurse Practitioner | Choctaw Nation of Oklahoma | 1 Choctaw Way, Talihina, OK 74571-2022 |
| Street Address |
109 KERR BLVD |
| City | POTEAU |
| State | OK |
| Zip | 74953-5231 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Frank J Smith | Physician Assistant | Choctaw Nation of Oklahoma | 109 Kerr Blvd, Poteau, OK 74953-5231 |
| Elizabeth M Feltner | Podiatry | Choctaw Nation of Oklahoma | 109 Kerr Blvd, Poteau, OK 74953-5231 |
| Jennifer Evelyn Dillard | Optometry | Choctaw Nation of Oklahoma | 109 Kerr Blvd, Poteau, OK 74953-5231 |
| Dean N Anderson | Physician Assistant | Choctaw Nation of Oklahoma | 109 Kerr Blvd, Poteau, OK 74953-5231 |
| Alexander Blaschke | Podiatry | Choctaw Nation of Oklahoma | 109 Kerr Blvd, Poteau, OK 74953-5231 |
| John Rice | Physician Assistant | Choctaw Nation of Oklahoma | 109 Kerr Blvd, Poteau, OK 74953-5231 |
| Ty A Salness | Internal Medicine | Choctaw Nation of Oklahoma | 109 Kerr Blvd, Poteau, OK 74953-5231 |
| Jeffrey K Blue | Physician Assistant | Choctaw Nation of Oklahoma | 109 Kerr Blvd, Poteau, OK 74953-5231 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Lena Faye Burns | Nurse Practitioner | Healthmax Center LLC | 2202 N Broadway St, Poteau, OK 74953-2000 |
| Tracy Kay Fiser | Nurse Practitioner | Fort Smith Hma Pbc Management LLC | 1200 Central St, Poteau, OK 74953-2320 |
| Timothy Ray Olive | Nurse Practitioner | Mercy Clinic Fort Smith Communities | 2110 N Broadway St, Poteau, OK 74953-2501 |
| Steven C Dryer | Chiropractic | 2112 N Broadway St, Poteau, OK 74953-2501 | |
| Arthur W Pearson Iii | Family Medicine | Mercy Clinic Fort Smith Communities | 2110 N Broadway St, Poteau, OK 74953-2501 |
| Steven Paul Medeiros | Emergency Medicine | Steven P Medeiros Do Inc | 101 Smith Ave, Poteau, OK 74953-2613 |
| Skip H Baxter | Physical Therapy | 1932 N Broadway, Poteau, OK 74953-2638 | |
| Karolyn M Patterson | Physical Therapy | Physical Therapy, Inc | 1932 N Broadway, Poteau, OK 74953-2638 |
| James Edward Dunn | Optometry | 901 Grace St, Poteau, OK 74953-2817 | |
| Autumn R Hembree | Nurse Practitioner | T Jarel Brown Aprn-cnp Pllc | 210 W Robert St, Poteau, OK 74953-2942 |
| Find all physicians in zip 74953 | |||
| City | POTEAU |
| Zip Code | 74953 |
| Specialty | OPTOMETRY |
| City + Specialty | POTEAU + OPTOMETRY |
Please comment or provide details below to improve the information on Kelly K Boucher.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.