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FREDERICK THORNTON BOULWARE M.D. NPI 1497733174


NPI Information

NPI: 1497733174
Provider Name: FREDERICK THORNTON BOULWARE, M.D.
Classification: Psychiatry & Neurology - 2084N0400X
Entity Type: Individual

Specialization: Neurology

PECOS Registration: Yes

Address:
2423 W DUNLAP AVE
STE 130
PHOENIX, AZ
ZIP 85021
Phone: (602) 424-4450
Get Directions

Frederick Thornton Boulware, M.D. is a neurology psychiatry neurology in Phoenix, AZ with 59 years of experience. The provider is a Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. Frederick Thornton Boulware, M.D. NPI is 1497733174. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: MEHARRY MEDICAL COLLEGE SCHOOL OF MEDICINE
Graduation Year:1965

The provider's business location address is:

2423 W DUNLAP AVE
STE 130
PHOENIX, AZ
ZIP 85021-818
Phone: (602) 424-4450
Fax: (602) 424-4451

The NPI 1497733174 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Needle measurement and recording of electrical activity of muscles of arm or leg complete study (HCPCS:95886)
  • Nerve transmission studies, 9-10 studies (HCPCS:95911)
  • Observation, testing, and recording of abnormal eye movement (HCPCS:92540)
  • Nerve transmission studies, 7-8 studies (HCPCS:95910)

The enumeration date for this NPI number is 1/4/2006 and was last updated on 9/18/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12084N0600XPsychiatry & NeurologyClinical Neurophysiology37701ARIZONANo
22084N0008XPsychiatry & NeurologyNeuromuscular Medicine37701ARIZONANo
32084N0400XPsychiatry & NeurologyNeurology37701ARIZONAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1100500484MEDICAIDNEVADA
2104810MEDICARE PINNEVADA
3C95812MEDICARE UPINNEVADA
4002002038MEDICAIDNEVADA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.