Miranda L Bourgeois, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2001001888 Issued in MO

Practice address

3301 Berrywood Dr
Suite 204
Columbia, MO 65201-6517

Phone

(573) 449-6082

NPI assigned

Mar 29, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• BDM Associates LLC

  • Physical Therapist
  • Columbia, MO
  • NPI 1801847033
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426636800000",
    "number": "1043339849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 BERRYWOOD DR",
            "address_2": "SUITE 204",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652016517",
            "telephone_number": "573-449-6082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 BERRYWOOD DR",
            "address_2": "SUITE 204",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652016517",
            "telephone_number": "573-449-6082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURGEOIS",
        "first_name": "MIRANDA",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-29",
        "last_updated": "2015-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "3407",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2001001888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian Bostick, M.D.
• Blanca Cecilia Botero, PHARM.D.
• Mary Eliza Bottorff, PT
• James Bryce Boudreau
• Sabine Dessieux Boudreau, FNP
• Lorie Ann Bousquet, LPC
• Curtiss Boutwell, PHARM D
• Amy Nicole Bowers, DO
• Kelly Alexandra Bowers, DO
• Kyle S Bowers, DC

• Physical Therapist in Columbia, MO
• Providers in Columbia, MO by specialty
• Physical Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.