DINAH S. BOURDON ANP NPI 1124052568

NPI Information

  • NPI: 1124052568
  • Provider Name: DINAH S. BOURDON, ANP
  • Classification: Nurse Practitioner - 363LP0808X
  • Specialization: Psychiatric/Mental Health
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 501 BILLINGSLEY RD
    CHARLOTTE, NC
    ZIP 28211
  • Phone: (704) 358-2700

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NPI Details

Dinah S. Bourdon, ANP is a psychiatric/mental health nurse practitioner in Charlotte, NC. Dinah S. Bourdon, ANP NPI is 1124052568. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

501 BILLINGSLEY RD
CHARLOTTE, NC
ZIP 28211-009
Phone: (704) 358-2700
Fax: (704) 358-2716

The NPI 1124052568 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Power Mobility Devices.

The enumeration date for this NPI number is 7/10/2006 and was last updated on 5/10/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LP0808XNurse PractitionerPsychiatric/Mental Health900130NORTH CAROLINANo
2363LP0808XNurse PractitionerPsychiatric/Mental Health151301NORTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11124052568MEDICAIDNORTH CAROLINA
22599106MEDICARE PINNORTH CAROLINA
3S94660MEDICARE UPINNORTH CAROLINA
47005232MEDICAIDNORTH CAROLINA
52599106AMEDICARE PINNORTH CAROLINA
6NC3506AMEDICARE PINNORTH CAROLINA
7NP1545MEDICAIDSOUTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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