Active NPI
Kelly A Bourne, RN
- Registered Nurse
- Lynn, MA
National Provider Identifier
1083138671
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- RN2261075
- Practice address
- 62 Market St
Lynn, MA 01901 - Phone
- (339) 883-1212
- Fax
- (978) 595-5479
- NPI assigned
- Jul 26, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN2261075 | MA | Primary |
Addresses
Primary practice location
62 Market St
Lynn, MA 01901
Mailing address
37 Friend Street
Element Care Inc.
Lynn, MA 01902
Phone (781) 715-6608
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN2261075 | MA | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Element Care, Inc. | Past | Accepting new patients |
Interoperability endpoints
- kelly.bourne.p1@direct.elementcare.nextgenshare.com
Organizations & group practices 1
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.
-
- PACE Provider Organization
- Lynn, MA
- NPI 1184600660
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1501027200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1501027200000",
"number": "1083138671",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "37 FRIEND STREET",
"address_2": "ELEMENT CARE INC.",
"city": "LYNN",
"state": "MA",
"postal_code": "01902",
"telephone_number": "781-715-6608",
"fax_number": "781-715-6699"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "62 MARKET ST",
"city": "LYNN",
"state": "MA",
"postal_code": "01901",
"telephone_number": "339-883-1212",
"fax_number": "978-595-5479"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOURNE",
"first_name": "KELLY",
"middle_name": "A",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-07-26",
"last_updated": "2017-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "MA",
"license": "RN2261075",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lynn, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.