Vincent M Bournique, MD

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

01029804A Issued in IN

Practice address

8075 N Shadeland Ave
#350
Indianapolis, IN 46250-2693

Phone

(317) 678-3900

Fax

(317) 841-0395

NPI assigned

Apr 27, 2006

Last updated

Jan 18, 2017By the provider in NPPES

Sex

Male

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

Medicare fee-for-service enrollment

Enrolled in AZ

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Heart Partners of Indiana LLC

  • Cardiovascular Disease Physician
  • Indianapolis, IN
  • NPI 1669550588
  NPD (past)
• Indiana Heart Associates PC

  • Cardiovascular Disease Physician
  • Indianapolis, IN
  • NPI 1992821631
  NPD (past)
• Indiana University Health, Inc

  • Cardiovascular Disease Physician
  • Indianapolis, IN
  • NPI 1376586719
  NPD (past)
• Major Hospital

  • General Acute Care Hospital
  • Shelbyville, IN
  • NPI 1174555692
  NPD (past)

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484697600000",
    "number": "1144287681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 S 20TH AVE",
            "address_2": "#350",
            "city": "SAFFORD",
            "state": "AZ",
            "postal_code": "855464011",
            "telephone_number": "928-348-4037",
            "fax_number": "855-876-8606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8075 N SHADELAND AVE",
            "address_2": "#350",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502693",
            "telephone_number": "317-678-3900",
            "fax_number": "317-841-0395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURNIQUE",
        "first_name": "VINCENT",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2017-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IN",
            "license": "01029804A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10385690",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Bouman
• Bounce Back Physical Therapy
• Bourke Homecare LLC
• Shawn L Bourke, NP
• Matthew Bourne, MS COUNSELING
• Kristen Bourque, RD, LD, CLC
• Alexandria Bousamra-Wright, APRN
• John Steven Bousamra
• Elizabeth Bouse, D.C.
• Amber J Boushehry, MSW, LCSW

• Cardiovascular Disease Physician in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Cardiovascular Disease Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.