Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kelly J Bouchonville, PA-C

Individual provider Physician Assistant · NPI 1154024586

Kelly J Bouchonville, PA-C is a Physician Assistant in Iowa City, Iowa. Graduated from Yale University School of Medicine in 2022, 4 years ago. Practices with State University of Iowa, a 1,885-clinician group and accepts Medicare assignment. Licensed in Iowa and Minnesota.

Years since qualifying
4
Trained at
Yale University School of Medicine
Licensed in
IA, MN
In the registry since
2023
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

200 Hawkins Dr
Iowa City, IA 52242-1009
Phone: (319) 356-8133
Fax: (319) 356-2999
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 124548 (IA)
Physician Assistant Taxonomy 363A00000X · Licence 14257 (MN)

Record details

NPI number1154024586
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedMarch 24, 2023
Last updated in NPPESAugust 21, 2025
Certification dateAugust 21, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolYALE UNIVERSITY SCHOOL OF MEDICINE
Graduated 2022 (4 years in practice)
Group practice State University Of Iowa — 1885 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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