DR. DALTON BOURKE (NPI# 1134623804) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134623804 |
| Entity Type | Individual |
| Full Name | DR. DALTON BOURKE |
| Credential | MD |
| Practice Address |
601 South Edwin C Moses Blvd Dayton OH 45417-3424 |
| Practice Telephone | 9377348333 |
| Mailing Telephone | 9377348333 |
| Enumeration Date | 2018-03-19 |
| Last Update Date | 2020-07-31 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
57.246588 | OH | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
601 SOUTH EDWIN C MOSES BLVD |
| City | DAYTON |
| State | OH |
| Zip Code | 45417-3424 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316919137 | Amy B Jones | Social Worker | 601 South Edwin C Moses Blvd, Dayton, OH 45417-3424 | 2006-02-06 |
| 1942809660 | Michelle Toops | Registered Nurse | 601 South Edwin C Moses Blvd, Dayton, OH 45417-3424 | 2020-10-23 |
| 1912505579 | Anna B Chambers | Registered Nurse | 601 South Edwin C Moses Blvd, Dayton, OH 45417-3424 | 2020-10-15 |
| 1639776057 | Johnna G Kovach | Social Worker | 601 South Edwin C Moses Blvd, Dayton, OH 45417-3424 | 2020-10-08 |
| 1083229751 | Jenna J Branam | Registered Nurse | 601 South Edwin C Moses Blvd, Dayton, OH 45417-3424 | 2020-09-10 |
| 1982219549 | Sarah A Long | Case Manager/Care Coordinator | 601 South Edwin C Moses Blvd, Dayton, OH 45417-3424 | 2020-09-10 |
| 1447863550 | Jennifer Marshall | Registered Nurse | 601 South Edwin C Moses Blvd, Dayton, OH 45417-3424 | 2020-08-28 |
| 1174136436 | Ericka Hughes | Social Worker | 601 South Edwin C Moses Blvd, Dayton, OH 45417-3424 | 2020-08-26 |
| 1437760592 | Megan Schrodi | Social Worker | 601 South Edwin C Moses Blvd, Dayton, OH 45417-3424 | 2020-08-12 |
| 1174132922 | Emily M Hunter | Registered Nurse | 601 South Edwin C Moses Blvd, Dayton, OH 45417-3424 | 2020-07-28 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891329504 | Kanika Crowder | Home Health Aide | 5964 Hoover Ave, Dayton, OH 45417 | 2020-03-03 |
| 1427510510 | Michael S Hatesohl | Student in an Organized Health Care Education/Training Program | 627 South Edwin C. Moses Blvd., East Medical Plaza, 1st Floor, Dayton, OH 45417 | 2019-04-05 |
| 1205313350 | Latonda T Brewer | Home Health Aide | 3900 Cone Ct, Dayton, OH 45417 | 2018-07-22 |
| 1205326048 | Diane Fillmore | Case Manager/Care Coordinator | 1818 West Main Street, Dayton, OH 45417 | 2018-05-17 |
| 1295222941 | Zainab Saherwala | Student in an Organized Health Care Education/Training Program | 627 S. Edwin C. Moses, East Medical Plaza, 1st Floor, Dayton, OH 45417 | 2018-04-18 |
| 1013430123 | Bridgette Elizabeth Quinlin | Counselor | 4104 Germantown St, Dayton, OH 45417 | 2017-07-20 |
| 1083144679 | Tadesha Marie Gay | Licensed Practical Nurse | 4748 Ericson Ave, Dayton, OH 45417 | 2017-06-15 |
| 1386180099 | Bio-medical Applications of Ohio, Inc. | Clinic/Center | 821 S Edwin C Moses Blvd, Dayton, OH 45417 | 2017-01-19 |
| 1770039760 | Jamie E Denlinger | Social Worker | 1 Elizabeth Pl Fl 3, Dayton, OH 45417 | 2016-08-30 |
| 1780069823 | Care4us Behavioral Health Center, LLC | Community/Behavioral Health | 1 Elizabeth Place, Ste 1170, Dayton, OH 45417 | 2015-07-29 |
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| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407406697 | New Life Ketamine Clinic LLC | Psychiatry & Neurology | 7905 Schatz Pointe Dr Ste 100, Dayton, OH 45459-3856 | 2019-09-19 |
| 1558896100 | Elizabeth Schindler | Psychiatry & Neurology | 301 South Edwin C Moses Blvd, Dayton, OH 45417-3424 | 2017-04-20 |
| 1538579768 | Kari Sharyce Harper | Psychiatry & Neurology | Wright State University 3640 Colonel Glenn Hwy, Dayton, OH 45435-0001 | 2014-04-28 |
| 1629415443 | Musammar Ghani | Psychiatry & Neurology | Wsu, Dept of Psychiatry, 627 Edwin C. Moses Boulevard, Elizabeth Place, E. Medical Plaza, 1st Floor, Dayton, OH 45417 | 2013-06-03 |
| 1316293277 | John Robert Weiffenbach | Psychiatry & Neurology | 1 Wyoming St Ste 3115, Dayton, OH 45409-2722 | 2012-07-30 |
| 1528325933 | James Gibson Pennington | Psychiatry & Neurology | 1800 Van Patton Dr, Dayton, OH 45433-5335 | 2012-04-23 |
| 1134459878 | Theresa Bernadette Belen | Psychiatry & Neurology | 627 S. Edwin C. Moses Blvd., Wsusom Department of Psychiatry, Dayton, OH 45417-1461 | 2009-12-31 |
| 1184871782 | Aradhana Gill | Psychiatry & Neurology | 1020 Wild Hickory Ln, Dayton, OH 45458-6092 | 2008-08-26 |
| 1376714675 | Ryan Christopher Mast | Psychiatry & Neurology | 627 South Edwin C. Moses Blvd, Dayton, OH 45408-1461 | 2008-03-14 |
| 1417148784 | Braumiller Psychiatric Associates, Inc. | Psychiatry & Neurology | 143 Valentine Dr, Dayton, OH 45431-1923 | 2007-08-02 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.