Dr Jerri Anne Boughan, DMD is a medicare enrolled "Dentist" provider in Lawrenceville, Illinois. Her current practice location is
2300 James St, Lawrenceville, Illinois. You can reach out to her office (for appointments etc.) via phone at
(618) 943-5664.
Dr Jerri Anne Boughan is licensed to practice in Illinois (license number 019024088) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1982719431.
Healthcare Provider's Profile
Full Name | Dr Jerri Anne Boughan |
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Gender | Female |
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Speciality | Dentist |
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Location | 2300 James St, Lawrenceville, Illinois |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1982719431
- Provider Enumeration Date: 08/21/2006
- Last Update Date: 06/02/2015
Medicare PECOS Information:
- PECOS PAC ID: 8123280369
- Enrollment ID: I20150609001717
Medical Identifiers
Medical identifiers for Dr Jerri Anne Boughan such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1982719431 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
122300000X | Dentist | 019024088 (Illinois) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Jerri Anne Boughan is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Dr Jerri Anne Boughan, DMD 2300 James St, Lawrenceville, IL 62439-2089 Ph: (618) 943-5664 | Dr Jerri Anne Boughan, DMD 2300 James St, Lawrenceville, IL 62439-2089 Ph: (618) 943-5664 |
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