RANDI NICOLE BOUCHILLON DNP, FNP-C - NPI 1437888138 - Nurse Practitioner in Prince Frederick, MD

Q: What is the provider's specialty?

The provider's specialty is Nurse Practitioner with taxonomy code 363LF0000X and a focus in Family.

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About Randi Nicole Bouchillon Dnp, Fnp-c NPPES

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

RANDI NICOLE BOUCHILLON DNP, FNP-C (NPI 1437888138) is an individual family provider in Prince Frederick, Maryland, licensed in Maryland (R244896) and active in the NPI registry since June 2022. She is enrolled in Medicare PECOS and is a graduate of Other (2022).

NPPES Registry Identity

NPI1437888138

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameRANDI NICOLE BOUCHILLONCredential: DNP, FNP-C

Location Address85 HOSPITAL RDPrince Frederick, MD 20678-4018

Mailing Address85 Hospital RdPrince Frederick, MD 20678-4018 · (240) 717-9661 · Fax (410) 535-1505

Phone(410) 535-2300

Fax(410) 535-1505

Sole ProprietorNo

Medical School CMSOtherGraduated 2022

Enumeration DateJune 8, 2022

Last NPPES UpdateMay 26, 20265 updates tracked since enumeration

NPPES CertifiedMay 26, 2026

✔ NPI 1437888138 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in MD · R244896

Also ListedRegistered Nurse · PediatricsTaxonomy 163WP0200X · License R244896 (MD)

85 HOSPITAL RD, Prince Frederick, MD 20678

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Other Identifiers 2

Medicaid815444357MD

OtherR244896MD · Rn

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Randi Nicole Bouchillon Dnp, Fnp-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID5092299792

PECOS Enrollment IDI20260320001095

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 20678 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$89.75 typical visit price

range $57.99 – $175.57

Typical copayment $22.43 (range $14.49 – $43.89)

Most-billed visit code 99203

Established Patient

$102.11 typical visit price

range $18.66 – $143.02

Typical copayment $25.52 (range $4.66 – $35.75)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 9

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

SHARENE GORDON PT

Physical Therapist