Jessica Ann Bourgeois, D.O.
Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Lititz, PA
NPI 1063252674 · NPPES record last updated May 30, 2024
Key facts
- NPI
- 1063252674
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Student in an Organized Health Care Education/Training Program 390200000X
- Practice address
- 1500 Highlands Drive
Lititz, PA 17543 - Phone
- (717) 625-5646
- NPI assigned
- May 30, 2024
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240614000842 | PA | Order and Referring Only - Family Practice |
2062955347 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | PA | Yes |
Addresses
Primary practice location
1500 Highlands Drive
Lititz, PA 17543
Mailing address
3600 Forbes Avenue
Forbes Tower - Plaza Level Suite 140
Pittsburgh, PA 15213
Other names
- Jessica Ann Fleury
Other providers in Lititz, PA
- Bluebird Counseling Center LLC
- Jessica Bodene
- Lucineia Boesing
- Janae Bollinger
- Elizabeth Borders
- Mackenzi Bowman
- Charles E Boyd Jr.
- Maria Cristina Bradley
- Emily Christine Brandt
- Jennifer Brandt
All providers in Lititz, PA · Student in an Organized Health Care Education/Training Program in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 30, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.