NPI Code Detail JSON Logo

1982579306 NPI number — REBEKKA BOUCHER

NPI Number: 1982579306
Health Care Provider/Practitioner: REBEKKA BOUCHER

Information about “1982579306” NPI (REBEKKA BOUCHER) exists in 1982579306 in HTML format HTML  |  1982579306 in plain Text format TXT  |  1982579306 in PDF (Portable Document Format) PDF  |  1982579306 in an XML format XML  formats.

NPI Number : 1982579306 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1982579306",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "BOUCHER",
    "FirstName": "REBEKKA",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "53 WEST ST APT 2",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "NEW BRITAIN",
    "MailingAddressStateName": "CT",
    "MailingAddressPostalCode": "06051-5800",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "860-532-9760",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "53 WEST ST APT 2",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "NEW BRITAIN",
    "PracticeLocationAddressStateName": "CT",
    "PracticeLocationAddressPostalCode": "06051-5800",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "860-532-9760",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "10/07/2025",
    "LastUpdateDate": "10/07/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "X",
    "Gender": null,
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "225700000X",
        "TaxonomyName": "Massage Therapist",
        "LicenseNumber": "11540",
        "LicenseNumberStateCode": "CT",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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