Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1659834323 Individual Practitioner Male Practitioner

Dr. Mark Ricard Boudreau , DO

Pediatrics • Rome, GA

Professional Overview & Biography Verified Profile Summary

Dr. Mark Boudreau, DO is a registered healthcare professional specializing in Pediatrics in Rome, GA. Practice services are available at 304 SHORTER AVE NW STE 105 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

304 Shorter Ave Nw Ste 105

Rome, GA 301654256

Telephone 7062364880
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Pediatrics in Rome, GA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 34.0 Yrs
State Avg: 21.2 Yrs
Regional Practice Density
19 Specialists

Practicing in Rome, GA (2326 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2023-05-26
Pediatrics Primary Specialty

NUCC Taxonomy Code: 208000000X

State License GA 11273

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Secondary Practice Locations

2370 Rockmart Hwy Ste 100

Cedartown, GA 301256029

Phone: 7707487818

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

5 Associated Practitioners
Amanda Ingram , NP

Nurse Practitioner - Primary Care

NPI 1558856401

Nurse Practitioner

NPI 1679513360

Doctor of Medicine (M.D.)

NPI 1750630349

Doctor of Medicine (M.D.)

NPI 1770760399

Doctor of Medicine (M.D.)

NPI 1891712535

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

14 Historical Events
🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) March 07, 2023

Pediatrics (License #11273 in GA)

📍
Updated Practice Location November 17, 2022

Registered at 304 SHORTER AVE NW STE 105, ROME, GA 301654256 (Tel: 7062364880)

📍
Updated Practice Location August 08, 2022

Registered at 2370 ROCKMART HWY STE 100, CEDARTOWN, GA 301256029 (Tel: 7707487818)

📍
Updated Business Mailing Address August 08, 2022

Registered at 420 E 2ND AVE STE 103, ROME, GA 301613210 (Tel: 7065093000)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 08, 2022

Student in an Organized Health Care Education/Training Program

📍
Updated Practice Location July 11, 2019

Registered at 744 1ST ST, MACON, GA 312016840 (Tel: 4786337500)

📍
Updated Business Mailing Address July 11, 2019

Registered at 744 1ST ST, MACON, GA 312016840 (Tel: 4786337500)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 11, 2019

Pediatrics (License #11273 in GA)

NPI Profile Active April 10, 2019

NPI status registered as active in NPPES database

📍
Updated Practice Location April 10, 2019

Registered at 777 HEMLOCK STREET, MACON, GA 31201 (Tel: 4786331634)

📍
Updated Business Mailing Address April 10, 2019

Registered at 11302 DEEP POND DR, COLLIERVILLE, TN 38017 (Tel: 9018718688)

👤
Provider Name / Credentials Updated April 10, 2019

Recorded as MARK BOUDREAU, DO

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) April 10, 2019

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration April 10, 2019

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1659834323
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 10, 2019
Last Update: May 26, 2023
Sole Proprietor: No

Mailing Address

420 E 2nd Ave Ste 103

Rome, GA 301613210

Phone: 7065093000

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.