BRAD BOURGEOIS (NPI# 1982066783) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982066783 |
| Entity Type | Individual |
| Full Name | BRAD BOURGEOIS |
| Practice Address |
201 N Lakemont Ave Winter Park FL 32792-3228 |
| Mailing Address |
5842 Sundown Cir Apt 621 Orlando FL 32822-9452 |
| Practice Telephone | 4077904205 |
| Mailing Telephone | 9852097381 |
| Enumeration Date | 2016-03-22 |
| Last Update Date | 2019-01-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | AP08638 | LA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 2416243 | 05 |
| Street Address |
201 N LAKEMONT AVE |
| City | WINTER PARK |
| State | FL |
| Zip Code | 32792-3228 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558360206 | Jared P. Reiss | Physician Assistant | 201 N Lakemont Ave, 700, Winter Park, FL 32792-3228 | 2005-07-15 |
| 1144752239 | Alex Orandi | Nurse Practitioner | 201 N Lakemont Ave, Winter Park, FL 32792-3228 | 2017-03-29 |
| 1295106334 | Doc Pam, Pa | Clinic/Center | 201 N Lakemont Ave, Suite 200, Winter Park, FL 32792-3228 | 2015-10-15 |
| 1598133993 | Js Healthcare, Inc | Clinic/Center | 201 N Lakemont Ave, Suite 2300, Winter Park, FL 32792 | 2015-09-02 |
| 1487093316 | Comprehensive Dermatology and Dermatologic Surgery, Plc | Dermatology | 201 N Lakemont Ave, Suite 100, Winter Park, FL 32792-3228 | 2013-06-25 |
| 1467795286 | Florida Vein Care Specialists, LLC | Surgery | 201 N Lakemont Ave, Ste 700, Winter Park, FL 32792-3228 | 2013-03-29 |
| 1346423308 | Jenelle Hovde | Audiologist | 201 N Lakemont Ave, Suite 100, Winter Park, FL 32792-3228 | 2007-12-13 |
| 1225239072 | Christopher Savage | Otolaryngology | 201 N Lakemont Ave, Suite 100, Winter Park, FL 32792-3228 | 2007-05-30 |
| 1639388762 | Thomas Charles Lawton | Dentist | 201 N Lakemont Ave, Suite 400, Winter Park, FL 32792-3228 | 2007-05-22 |
| 1225159437 | Brett Thomas Lawton | Dentist | 201 N Lakemont Ave, Suite 400, Winter Park, FL 32792-3228 | 2007-04-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225647589 | Interim Personal Care Services, LLC | Home Health | 1890 State Road 436, Suite 355, Winter Park, FL 32792 | 2020-07-23 |
| 1710510649 | Chrisline Badio | Clinic/Center | 3040 Aloma Ave Apt J12, Winter Park, FL 32792 | 2020-02-19 |
| 1679112411 | The Local Health Council of East Central Florida, Inc. | Voluntary or Charitable | 5931 Brick Court, Suite 164, Winter Park, FL 32792 | 2019-12-26 |
| 1710534201 | Robert Scott Hughes | Occupational Therapy Assistant | 925 South Semoran Blvd, #110a, Winter Park, FL 32792 | 2019-08-20 |
| 1164077962 | Dentists of Winter Park, Pa | Dentist | 1973 Aloma Avenue, Winter Park, FL 32792 | 2019-08-08 |
| 1659938637 | Adventist Health System/sunbelt Inc Dba Adventhealth Orlando | Pharmacy | 2005 Mizell Avenue, Suite 900, Winter Park, FL 32792 | 2019-05-24 |
| 1104397801 | Jose M Martinez Rivera | Chiropractor | 471 N Semoran Blvd., Suite B, Orlando, FL 32792 | 2018-12-07 |
| 1750875720 | Andrea Nalborczyk | Student in an Organized Health Care Education/Training Program | 133 Benmore Dr #200, Winter Park, FL 32792 | 2018-06-21 |
| 1841787157 | Rd Health Diagnostic LLC | Clinical Medical Laboratory | 6904 Aloma Ave, Winter Park, FL 32792 | 2018-04-23 |
| 1548763006 | Daniel Remington Geer | Hearing Instrument Specialist | 7007 University Blvd, Winter Park, FL 32792 | 2018-03-12 |
| Find all providers in zip 32792 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891343661 | Iveth Mastrapa | Nurse Practitioner | 3727 N Goldenrod Rd Ste 106, Winter Park, FL 32792-8611 | 2019-08-26 |
| 1578119723 | Phoenix Integrated Medical Center | Nurse Practitioner | 2425 Lee Rd, Winter Park, FL 32789-1747 | 2019-08-14 |
| 1336600931 | Linda Louise Gilliland | Nurse Practitioner | 601 N New York Ave Ste 101, Winter Park, FL 32789-3103 | 2019-03-27 |
| 1356881759 | Sandy J Hutnick | Nurse Practitioner | 976 Orange Ave Ste B, Winter Park, FL 32789-4760 | 2017-03-03 |
| 1437542750 | Santi Rekha Chellu | Nurse Practitioner | 483 N Semoran Blvd Ste 103, Winter Park, FL 32792-3800 | 2015-03-11 |
| 1114298270 | Kerin Lee Howe | Nurse Practitioner | 113 N Orlando Ave, Winter Park, FL 32789-3675 | 2012-01-21 |
| 1508017005 | Threshold Health Systems | Nurse Practitioner | 3550 N Goldenrod Rd Ste 1, Winter Park, FL 32792-8823 | 2008-10-02 |
| 1184727125 | Hannah Marie Foley | Nurse Practitioner | 145 Parsenn Rd, Winter Park, CO 80482 | 2006-09-06 |
| 1871519769 | Kathryn Taylor Hollingsworth | Nurse Practitioner | 1400 S Orlando Avenue, Ste 210, Winter Park, FL 32789 | 2006-07-14 |
| 1053393249 | Sandra Ruby Weisstein | Nurse Practitioner | 1000 Holt Ave, 2727, Winter Park, FL 32789-4499 | 2005-11-15 |
| Find all providers in WINTER PARK | ||||
| City | WINTER PARK |
| Zip Code | 32792 |
Please comment or provide details below to improve the information on BRAD BOURGEOIS.
| 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.