Michelle L Bourne, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1164 Issued in OK

Practice address

2080 Hwy 9 West
Norman, OK 73072

Phone

(405) 322-6800

NPI assigned

Jul 20, 2005

Last updated

Feb 12, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Michelle L Trumble Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Integris Ambulatory Care Corporation

  dba INTEGRIS Medical Group

  • Family Medicine Physician
  • Oklahoma City, OK
  • NPI 1750333936
  NPD (past)
• Integris Rural Health Inc

  dba Integris Canadian Valley Family Care Clinic

  • Family Medicine Physician
  • Mustang, OK
  • NPI 1962403030
  NPD (past)
• Marshall County Hma LLC

  dba INTEGRIS Kingston Medical Clinic

  • Family Medicine Physician
  • Kingston, OK
  • NPI 1659372712
  NPD (past)
• Marshall County HMPN, LLC

  • Family Medicine Physician
  • Madill, OK
  • NPI 1780955898
  NPD (past)
• NRHS West Family Medicine Associates

  • Family Medicine Physician
  • Norman, OK
  • NPI 1497035117
  NPD (past)

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

{
    "created_epoch": "1121817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392163200000",
    "number": "1124027263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4008 WOOD CASTLE ST",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730721795",
            "telephone_number": "405-919-8490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2080 HWY 9 WEST",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "73072",
            "telephone_number": "405-322-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURNE",
        "first_name": "MICHELLE",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-20",
        "last_updated": "2014-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "1164",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100138520A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "TRUMBLE",
            "middle_name": "L",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sydney Lorraine Boothe, APRN-BC, DNP
• Steven Franklin Borden
• Chad E. Borin
• Vicki Lynn Borycki, OTR/L
• Katie Bottoms
• Cassandra Bournival, LMFT
• Elissa Brielle Boutharouit
• Heather J Bowen, LPC
• Jennifer Kay Bowen, M.A., LPC
• Philip Don Bowen, M.S.W./L.C.S.W.

• Physician Assistant in Norman, OK
• Providers in Norman, OK by specialty
• Physician Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2014; 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.