DR. JOHN FRAZIER BOUTWELL DDS
NPI 1770108102
Dentist in Greenville, SC

Q: What is John Boutwell's NPI number?

The NPI number for John Boutwell is 1770108102. It was assigned to this individual provider in the NPPES registry on June 11, 2020.

Q: What is John Boutwell's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Q: When was this NPI record last updated?

The NPPES record for John Boutwell was last updated on January 20, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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 11, 2020PECOS Enrolled

3369 PELHAM RD, GREENVILLE, SC 29615(864) 297-6365 Get Directions Write a Review

NPPES record last updated: January 20, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jan 20, 2022, Jun 11, 2020 (2 updates tracked since 2020).

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About Dr. John Frazier Boutwell Dds NPPES

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

DR. JOHN FRAZIER BOUTWELL DDS (NPI 1770108102) is an individual dentist in Greenville, South Carolina, licensed in South Carolina (9855) and active in the NPI registry since June 2020. He is enrolled in Medicare PECOS and maintains a secondary practice location in Covington.

NPPES Registry Identity

NPI1770108102

Entity TypeIndividualMale

Primary Taxonomy122300000X

Provider Legal NameDR. JOHN FRAZIER BOUTWELLCredential: DDS

Location Address3369 PELHAM RDGreenville, SC 29615-4105

Mailing Address3369 Pelham RdGreenville, SC 29615-4105 · (864) 297-6365

Phone(864) 297-6365

Sole ProprietorYes

Enumeration DateJune 11, 2020

Last NPPES UpdateJanuary 20, 20222 updates tracked since enumeration

NPPES CertifiedJanuary 20, 2022

✔ NPI 1770108102 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers

Taxonomy Code122300000X

Licenses✔ Licensed in SC · 9855✔ Licensed in LA · 7099

Definition

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

3369 PELHAM RD, Greenville, SC 29615

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Secondary Practice Location 1

Location 1600 N Highway 190 Ste 4Covington, LA 70433-5083 · Phone (985) 893-5522

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. John Frazier Boutwell Dds is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 29615 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

$83.18 typical visit price

range $53.57 – $163.84

Typical copayment $20.79 (range $13.39 – $40.96)

Most-billed visit code 99203

Established Patient

$67.12 typical visit price

range $16.96 – $133.52

Typical copayment $16.78 (range $4.24 – $33.38)

Most-billed visit code 99213

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 4

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

NATHANIEL TAYLOR CALVERT

Dentist

3369 PELHAM RD
GREENVILLE, SC 29615

Greenville County (864) 297-6365

DR. SHANNON C HUDSON DDS

Dentist (General Practice)

3369 PELHAM RD
GREENVILLE, SC 29615

Greenville County (864) 297-6365

DR. ROBERT F POWELL JR. DDS

Dentist (General Practice)

3369 PELHAM RD
GREENVILLE, SC 29615

Greenville County (864) 297-6365

DR. KYLE S GREER DMD

Dentist (General Practice)

3369 PELHAM RD
GREENVILLE, SC 29615

Greenville County (864) 297-6365

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 John Boutwell's NPI number?

The NPI number for John Boutwell is 1770108102. It was assigned to this individual provider in the NPPES registry on June 11, 2020.

Where is John Boutwell located?

John Boutwell practices at 3369 Pelham Rd, Greenville, SC 29615. The listed phone number is (864) 297-6365.

What is John Boutwell's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Is John Boutwell enrolled in Medicare?

Yes. John Boutwell is registered in the Medicare PECOS enrollment system.

What insurance does John Boutwell accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health, Ambetter from Superior HealthPlan and Anthem Blue Cross and Blue Shield and 7 other insurers list John Boutwell 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 John Boutwell was last updated on January 20, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.