MR. RANDY ROLAND BOUCHER IDC
NPI 1356500938
Military Health Care Provider - Independent Duty Corpsman in Portsmouth, VA

Q: What is Randy Boucher's NPI number?

The NPI number for Randy Boucher is 1356500938. It was assigned to this individual provider in the NPPES registry on June 9, 2008.

Q: What is Randy Boucher's specialty?

The primary specialty registered for this NPI is Military Health Care Provider, specializing in Independent Duty Corpsman, with taxonomy code 1710I1002X.

Q: When was this NPI record last updated?

The NPPES record for Randy Boucher was last updated on June 9, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 09, 2008

620 JOHN PAUL JONES CIR, PORTSMOUTH, VA 23708(757) 953-5080 Get Directions Write a Review

NPPES record last updated: June 9, 2008. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Mr. Randy Roland Boucher Idc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. RANDY ROLAND BOUCHER IDC (NPI 1356500938) is an individual independent duty corpsman provider in Portsmouth, Virginia and active in the NPI registry since June 2008.

NPPES Registry Identity

NPI1356500938

Entity TypeIndividualMale

Primary Taxonomy1710I1002X

Provider Legal NameMR. RANDY ROLAND BOUCHERCredential: IDC

Location Address620 JOHN PAUL JONES CIRPortsmouth, VA 23708-2111

Mailing Address620 John Paul Jones CirPortsmouth, VA 23708-2111 · (757) 953-5080

Phone(757) 953-5080

Sole ProprietorNo

Enumeration DateJune 9, 2008

✔ NPI 1356500938 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMilitary Health Care Provider · Independent Duty CorpsmanOther Service Providers

Taxonomy Code1710I1002X

Definition

A Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and other supporting forces such as contractors and foreign nationals.

620 JOHN PAUL JONES CIR, Portsmouth, VA 23708

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MEREDITH TVERDOSI CRNA

Nurse Anesthetist, Certified Registered

620 JOHN PAUL JONES CIR
PORTSMOUTH, VA 23708

Portsmouth City (757) 953-3238

ERIC FRANCIS SULAVA

Emergency Medicine

620 JOHN PAUL JONES CIR, NAVAL MEDICAL CENTER PORTSMOUTH
PORTSMOUTH, VA 23708

Portsmouth City (757) 953-0669

MRS. TIFFNY KUPER RHH

Dental Hygienist

620 JOHN PAUL JONES CIR
PORTSMOUTH, VA 23708

Portsmouth City (757) 953-2711

DR. LAKEISHA GOODE PHARMD

Pharmacist

620 JOHN PAUL JONES CIR
PORTSMOUTH, VA 23708

Portsmouth City (757) 953-7462

JASMINE WOOD MD

Surgery

620 JOHN PAUL JONES CIR
PORTSMOUTH, VA 23708

Portsmouth City (757) 953-1895

NICHOLAS FANSELOW

General Practice

620 JOHN PAUL JONES CIR
PORTSMOUTH, VA 23708

Portsmouth City (757) 953-0669

DR. DAVID JESSEN MD

Military Health Care Provider

620 JOHN PAUL JONES CIR
PORTSMOUTH, VA 23708

Portsmouth City (757) 953-2518

MRS. WILLAR MAE BAUM L.C.S.W.

Social Worker (Clinical)

620 JOHN PAUL JONES CIR
PORTSMOUTH, VA 23708

Portsmouth City (757) 953-9767

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Randy Boucher's NPI number?

The NPI number for Randy Boucher is 1356500938. It was assigned to this individual provider in the NPPES registry on June 9, 2008.

Where is Randy Boucher located?

Randy Boucher practices at 620 John Paul Jones Cir, Portsmouth, VA 23708. The listed phone number is (757) 953-5080.

What is Randy Boucher's specialty?

The primary specialty registered for this NPI is Military Health Care Provider, specializing in Independent Duty Corpsman, with taxonomy code 1710I1002X.

When was this NPI record last updated?

The NPPES record for Randy Boucher was last updated on June 9, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.