DR. RENEE L BOULICAULT M.D.
NPI 1639148422
Hospitalist in Kingsport, TN
NPI Status: Active since March 15, 2006
Contact Information
105 W PARK DR
KINGSPORT, TN
ZIP 37660
Phone: (423) 224-3220
- Individual
- Female
- Hospitalist
- Accepts Insurance
- PECOS Enrolled
About RENEE BOULICAULT
This page provides the complete NPI Profile along with additional information for Renee Boulicault, a provider established in Kingsport, Tennessee with a medical specialization in Hospitalist. The healthcare provider is registered in the NPI registry with number 1639148422 assigned on March 2006. The practitioner's primary taxonomy code is 208M00000X with license number 70768 (TN). The provider is registered as an individual and her NPI record was last updated one year ago.
- NPI
- 1639148422
- Provider Name
- DR. RENEE L BOULICAULT M.D.
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 105 W PARK DR KINGSPORT, TN 37660
- Location Phone
- (423) 224-3220
- Mailing Address
- 1021 W OAKLAND AVE STE 310 JOHNSON CITY, TN 37604
- Mailing Phone
- (423) 952-2111
- Mailing Fax
- Is Sole Proprietor?
- No
- Enumeration Date
- 03-15-2006
- Last Update Date
- 09-05-2025
- Code Navigator
Location Map
Secondary Locations
- 1601 E Broadway Suite 100
Columbia, MO 65201
(573) 443-8796 - 3400 E Racine St
Janesville, WI 53546
(608) 373-8000
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Hospitalist
- Taxonomy Code
- 208M00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 70768
- License State
- TN
- Taxonomy Description
- Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 207V00000X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | 4868-320 (WI) |
| 2 | 207V00000X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | 103629 (MO) |
| 3 | 207V00000X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | 70768 (TN) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Balance by Medica Bronze $0 Copay PCP Visits - EPO
- Balance by Medica Bronze $0 Copay PCP Visits - PPO
- Balance by Medica Bronze Premier - EPO
- Balance by Medica Bronze Premier - PPO
- Balance by Medica Expanded Bronze Standard - EPO
- Balance by Medica Expanded Bronze Standard - PPO
- Balance by Medica Gold $0 Copay PCP Visits - EPO
- Balance by Medica Gold $0 Copay PCP Visits - PPO
- Balance by Medica Gold Share - EPO
- Balance by Medica Gold Share - PPO
- Balance by Medica Gold Standard - EPO
- Balance by Medica Gold Standard - PPO
- Balance by Medica Silver $0 Copay PCP Visits - EPO
- Balance by Medica Silver $0 Copay PCP Visits - PPO
- Balance by Medica Silver Share - EPO
- Balance by Medica Silver Share - PPO
- Balance by Medica Silver Standard - EPO
- Balance by Medica Silver Standard - PPO
- Harmony by Medica Bronze $0 Copay PCP Visits - PPO
- Harmony by Medica Bronze $0 Copay PCP Visits + Adult Eye Exam - PPO
- Peak PPO Bronze HDHP - PPO
- Peak PPO Bronze Standard - PPO
- Peak PPO Catastrophic - PPO
- Peak PPO Gold - PPO
- Peak PPO Gold Standard - PPO
- Peak PPO Silver - PPO
- Peak PPO Silver Standard - PPO
- Plus Bronze - PPO
- Plus Bronze Standard - PPO
- Plus Gold - PPO
- Plus Gold Standard - PPO
- Plus Silver Standard - PPO
- Rocky Mountain Bronze Standard - PPO
- Rocky Mountain Gold Standard - PPO
- Rocky Mountain Silver Standard - PPO
- PEAK PPO BRONZE - PPO
- PEAK PPO BRONZE HDHP - PPO
- PEAK PPO GOLD - PPO
- PEAK PPO GOLD HDHP - PPO
- PEAK PPO SILVER - PPO
- HSA Qualified 7500 Bronze - Choice Network - EPO
- HSA-E Qualified 7500 Bronze - Signature Network - EPO
- Providence Oregon Standard Bronze Plan - Choice Network - EPO
- Providence Oregon Standard Bronze Plan - Signature Network - EPO
- Providence Oregon Standard Gold Plan - Choice Network - EPO
- Providence Oregon Standard Gold Plan - Signature Network - EPO
- Providence Oregon Standard Silver Plan - Choice Network - EPO
- Providence Oregon Standard Silver Plan - Signature Network - EPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1639148422 | MEDICAID (05) | WI |
Medicare Participation & PECOS Enrollment Status
Renee Boulicault is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Cervical or vaginal cancer screening; pelvic and clinical breast examination
Established patient office or other outpatient visit, 20-29 minutes
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory
This procedure involves checking for health issues in the lower abdomen and chest area. It helps identify early signs of certain conditions, increasing the chance for successful treatment. It's a routine check-up that's important for maintaining good health.
This service was performed 55 times for 55 patientsThis is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
This service was performed 24 times for 18 patientsA Papanicolaou smear, often called a Pap smear, is a test to check for changes in cells. A small sample is gently collected from the lower region and sent to a lab for examination. This helps in early detection of potential health issues.
This service was performed 52 times for 52 patientsPhysician Visit Costs
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 37660 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $121.8
- Minimum New Patient Price $52.64
- Maximum New Patient Price $160.89
- Average New Patient Copayment $30.45
- Minimum New Patient Copayment $13.16
- Maximum New Patient Copayment $40.22
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $93.6
- Minimum Established Patient Price $16.72
- Maximum Established Patient Price $131.41
- Average Established Patient Copayment $23.4
- Minimum Established Patient Copayment $4.18
- Maximum Established Patient Copayment $32.85
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1639148422, we treat the final digit (2) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 68. The final step is to find the difference between that total and the next multiple of ten (70 - 68 = 2).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 68 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 8 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1639148422, enumerated as an "individual" on March 15, 2006.
The provider is located at 105 W PARK DR KINGSPORT, TN 37660 and the phone number is (423) 224-3220.
Hospitalist with taxonomy code 208M00000X.
The provider might be accepting Accepts: Medica, Mountain Health CO-OP, Providence Health. Please consult your insurance carrier or call the provider to verify.
