DINAH S. BOURDON ANP NPI 1124052568

NPI Information

NPI: 1124052568
Provider Name: DINAH S. BOURDON, ANP
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Individual

Specialization: Psychiatric/Mental Health

PECOS Registration: Yes

Address:
501 BILLINGSLEY RD
CHARLOTTE, NC
ZIP 28211
Phone: (704) 358-2700
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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 Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), 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
1	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	900130	NORTH CAROLINA	No
2	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	151301	NORTH CAROLINA	Yes

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
1	1124052568	MEDICAID	NORTH CAROLINA
2	2599106	MEDICARE PIN	NORTH CAROLINA
3	S94660	MEDICARE UPIN	NORTH CAROLINA
4	7005232	MEDICAID	NORTH CAROLINA
5	2599106A	MEDICARE PIN	NORTH CAROLINA
6	NC3506A	MEDICARE PIN	NORTH CAROLINA
7	NP1545	MEDICAID	SOUTH 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: 4/28/2024

NPI Synchronization or Removal

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