JACQUE A. BOUTWELL, JR. CFA – NPI #1013062405
Specialist/Technologist, Other

A surgical assistant is a skilled practitioner who has undergone formalized education and training as a surgical assistant. The surgical assistant performs surgical functions that include, but are not limited to: retracting, manipulating, suturing, clamping, cauterizing, litigating, and tying tissue; suctioning, irrigating and sponging; positioning the patient; closure of body planes and skin; and participating in hemostasis and volume replacement. Surgical assistants are certified and registered or licensed by the state, or, in states without licensure, certified as surgical assistants by completing appropriate education and training.

JACQUE BOUTWELL, JR. is a technologist located in ELKHART, IN. NPPES has assigned the NPI number 1013062405 to JACQUE BOUTWELL, JR. on January 24, 2007. It is a Type-1 NPI, indicating this NPI number is associated with an individual. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 246ZC0007X from the Health Care Provider Taxonomy code set, which is classified as Specialist/Technologist, Other, specializing in Surgical Assistant

The NPI profile was previously updated about 12 years ago on Nov 25, 2014. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for JACQUE BOUTWELL, JR. below.

NPI Profile for
JACQUE A. BOUTWELL, JR.

NPI Number
1013062405
Enumeration Date

(more than 19 years ago)
Entity Type
Type-1  Individual (Male)
Legal Name
JACQUE A. BOUTWELL, JR.
Credentials
CFA
Primary location
3301 COUNTY RD 6 E
ELKHART, IN 46514-7673
Phone: (574) 214-7504 Fax: (574) 262-3214
Mailing address
5146 RELIABLE PKWY
CHICAGO, IL 60686-0001
Phone: (574) 214-7504 Fax: (574) 262-3214
Sole Proprietor
No
Updated
Identifiers

Identifiers for JACQUE BOUTWELL, JR.

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
OTHERANTHEM BCBSIN000000577411
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.