Individual provider Active NPI

Angele D. Bourg, M.D.

  • Rheumatology Physician
  • Baton Rouge, LA
National Provider Identifier
1083655237
Registry record updated Feb 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
200583 Issued in LA
Practice address
7373 Perkins Rd
Baton Rouge, LA 70808-4326
Phone
(225) 769-4044
NPI assigned
Jun 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X 200583 LA Primary

Addresses

Primary practice location

7373 Perkins Rd
Baton Rouge, LA 70808-4326

Mailing address

7373 Perkins Rd
Baton Rouge, LA 70808-4326
Phone (225) 769-4044

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060324000172 LA Practitioner - RheumatologyPractitioner - Internal MedicinePractitioner - Orthopedic Surgery 6507874088 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Rheumatology
Education
Louisiana State University School of Medicine in Shreveport, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

230 Roberts Dr
Suite 1
New Roads, LA 70760-2661
Phone (225) 638-4585

7373 Perkins Rd
Baton Rouge, LA 70808-4326
Phone (225) 246-9790

7373 Perkins Rd
Baton Rouge, LA 70808-4373

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
200583LAMDRheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baton Rouge Clinic, a Medical Corporation Rheumatology CurrentSince Aug 1, 2006 Accepting new patients
Lsuhn Billing LLC CurrentSince Aug 27, 2010 Accepting new patients
Baton Rouge Clinic, a Medical Corporation CurrentSince Aug 1, 2006 Accepting new patients
Lsuhn Billing LLC CurrentSince Aug 27, 2010 Accepting new patients

Locations

7373 Perkins Rd
Baton Rouge, LA 70808
Phone (225) 246-9790

5131 Odonovan Dr
Baton Rouge, LA 70808
Phone (225) 374-0120

2390 W Congress St
Lafayette, LA 70506
Phone (337) 261-6000

Interoperability endpoints

  • Direct secure messaging: abourg4422@direct.casso.us.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488153600000",
    "number": "1083655237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7373 PERKINS RD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708084326",
            "telephone_number": "225-769-4044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7373 PERKINS RD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708084326",
            "telephone_number": "225-769-4044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURG",
        "first_name": "ANGELE",
        "middle_name": "D.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-09",
        "last_updated": "2017-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "LA",
            "license": "200583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

Verify at the official NPI Registry.