Jordan Lynn Boucher, RD
NPI 1215310669ActiveIndividual· Dietitian, Registered· Brockton, MA
Dietitian, Registered (RD) in Brockton, Massachusetts, licensed in WA, with an NPI issued in July 2015.
Overview
| NPI | 1215310669 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | RD |
| Sole proprietor | No |
| NPI issued | Jul 2, 2015 |
| Last updated in NPPES | May 4, 2020 |
| Certified by provider | May 4, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dietitian, Registered Primary | 133V00000X | DI 60543717 | WA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
Other Dietitian, Registered providers in Brockton
- 1457181703
- 1033976048
- 1245186139
- 1457718140
- 1487820080
- 1881940971
- 1902404981
- 1235703901
- 1457902967
- 1801816459
- 1659319499
- 1639492523