DR. RENEE L BOULICAULT M.D.
NPI 1639148422
Hospitalist in Kingsport, TN
About Dr. Renee L Boulicault M.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. RENEE L BOULICAULT M.D. (NPI 1639148422) is an individual hospitalist provider in Kingsport, Tennessee, licensed in Tennessee (70768) and active in the NPI registry since March 2006. She is enrolled in Medicare PECOS and maintains 2 additional practice locations.
NPPES Registry Identity
Specialties & Licenses 2
Secondary Practice Locations 2
Other Identifiers 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Dr. Renee L Boulicault M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
7Medicare enrollment records show Renee Boulicault reassigns Medicare billing to 7 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Kingsport, TN 37660
- Reassigned Medicare billing, Tennessee enrollment
- 861 clinicians in this Medicare group
Steelville, MO 65565
- Reassigned Medicare billing, Missouri enrollment
- Also billed through NPI 1245277631 (Missouri)
- 1,487 clinicians in this Medicare group
Columbia, MO 65201
- Reassigned Medicare billing, Missouri enrollment
- 17 clinicians in this Medicare group
Monroe, WI 53566
- Reassigned Medicare billing, Wisconsin enrollment
- 376 clinicians in this Medicare group
Madison, WI 53715
- Reassigned Medicare billing, Wisconsin enrollment
- 1,377 clinicians in this Medicare group
Miles City, MT 59301
- Reassigned Medicare billing, Montana enrollment
- 1,264 clinicians in this Medicare group
Boulder, MT 59632
- Reassigned Medicare billing, Montana enrollment
- 278 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 37660 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 12
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
KINGSPORT, TN 37660
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 Renee Boulicault's NPI number?
The NPI number for Renee Boulicault is 1639148422. It was assigned to this individual provider in the NPPES registry on March 15, 2006.
Where is Renee Boulicault located?
Renee Boulicault practices at 105 W Park Dr, Kingsport, TN 37660. The listed phone number is (423) 224-3220.
What is Renee Boulicault's specialty?
The primary specialty registered for this NPI is Hospitalist with taxonomy code 208M00000X.
Is Renee Boulicault enrolled in Medicare?
Yes. Renee Boulicault is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Renee Boulicault's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Renee Boulicault reassigns Medicare benefits to 7 organizations: Wellmont Medical Associates, Inc. (Kingsport, TN), Mercy Clinic Springfield Communities (Steelville, MO), Women's Health Associates, Inc. (Columbia, MO), The Monroe Clinic, Inc. (Monroe, WI), Dean Health Systems, Inc (Madison, WI) and 2 more organizations, listed in the Medicare section above. Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Renee Boulicault's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Renee Boulicault accept?
Health plans from Anthem Blue Cross and Blue Shield, Cigna Healthcare and Providence Health Plan list Renee Boulicault as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Renee Boulicault was last updated on September 5, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months 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.
# Dr. Renee L Boulicault, M.D. · NPI 1639148422
Hospitalist physician in Kingsport, Tennessee. Individual provider, active in the CMS NPPES registry since March 15, 2006.
## Identity
- **NPI:** 1639148422 (Entity type: Individual)
- **Enumerated:** March 15, 2006
- **Primary specialty:** Hospitalist · taxonomy 208M00000X
- **State license:** 70768 (Tennessee)
- **Sole proprietor:** No
## Practice location
- **Address:** 105 W PARK DR, Kingsport, TN 37660-3805
- **Phone:** (423) 224-3220
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 7 organizations under Medicare reassignment (form CMS-855R): Wellmont Medical Associates, Inc. (NPI 1598124398, Kingsport, TN); Mercy Clinic Springfield Communities (NPI 1669504411, Steelville, MO); Women's Health Associates, Inc. (NPI 1417926676, Columbia, MO); The Monroe Clinic, Inc. (NPI 1386720548, Monroe, WI); Dean Health Systems, Inc (NPI 1053358846, Madison, WI); and 2 more · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** September 5, 2025
- **Other identifiers:** Medicaid 1639148422 (WI)
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Source: [NPI Profile](https://npiprofile.com/npi/1639148422) · Data from the CMS NPPES public registry.