{"npi":"1639174675","type":"NPI-1","status":"active","name":{"display":"David Boucher MD","other":[],"first":"DAVID","last":"BOUCHER","credential":"MD"},"specialty":{"primary_taxonomy":"207R00000X","primary_taxonomy_description":"Internal Medicine","slug":"internal-medicine","schema_org_specialty":"Internal","all":[{"code":"207R00000X","description":"Internal Medicine","primary":true,"state":"TX","license":"G4848"}]},"addresses":[{"purpose":"LOCATION","street_1":"150 RIVER NORTH BLVD","city":"STEPHENVILLE","state":"TX","postal_code":"764011803","country_code":"US","phone":"2549686051","fax":"2549684204"},{"purpose":"MAILING","street_1":"150 RIVER NORTH BLVD","city":"STEPHENVILLE","state":"TX","postal_code":"764011803","country_code":"US","phone":"2549686051","fax":"2549684204"}],"license":{"state":"TX","number":"G4848"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"123772901","state":"TX","issuer":null},{"type_code":"01","label":"Other","value":"010016274","state":"TX","issuer":"RAILROAD MEDICARE PROV NO"},{"type_code":"01","label":"Other","value":"2060508001","state":"TX","issuer":"CIGNA PROVIDER NUMBER"},{"type_code":"01","label":"Other","value":"72486303","state":"TX","issuer":"UNITED HEALTHCARE PROV NO"},{"type_code":"01","label":"Other","value":"814765","state":"TX","issuer":"BCBS PROVIDER NUMBER"},{"type_code":"01","label":"Other","value":"72486303","state":"TX","issuer":"AETNA PROVIDER NUMBER"}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20070417000412","type_code":"14-11","type_desc":"PRACTITIONER - INTERNAL MEDICINE","state":"TX","pac_id":"3870588759"}]},"enumeration_date":"2005-06-16","last_updated":"2022-10-06","_meta":{"source":"NPPES","snapshot_date":"2022-10-06","doc_url":"https://findmynpi.com/api"}}