Mary Evelyn Bourland, MD

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

E4355 Issued in AR

Practice address

2708 Rife Medical LN
Suite 210
Rogers, AR 72758-1452

Phone

(479) 338-3888

Fax

(479) 338-4453

NPI assigned

May 3, 2006

Last updated

May 3, 2008By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

• Mercy Health Northwest Arkansas Communities

  • Multi-Specialty Clinic/Center
  • Rogers, AR
  • NPI 1265490916
  NPD (past)
• Mercy Health Northwest Arkansas Communities

  • Endocrinology, Diabetes & Metabolism Physician
  • Rogers, AR
  • NPI 1770087371
  NPD (past)
• Heart and Vascular Care, P. C.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Joplin, MO
  • NPI 1427160514
  NPD (past)
• Mercy Clinic Joplin LLC

  • Family Medicine Physician
  • Joplin, MO
  • NPI 1215264817
  NPD (past)

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209772800000",
    "number": "1164480679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2708 RIFE MEDICAL LN",
            "address_2": "SUITE 210",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727581452",
            "telephone_number": "479-338-3888",
            "fax_number": "479-338-4453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2708 RIFE MEDICAL LN",
            "address_2": "SUITE 210",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727581452",
            "telephone_number": "479-338-3888",
            "fax_number": "479-338-4453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURLAND",
        "first_name": "MARY",
        "middle_name": "EVELYN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-03",
        "last_updated": "2008-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "AR",
            "license": "E4355",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "122998001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laura L Bonner, D.D.S., M.S.
• Boozman-Hof Regional Eye Clinic
• Boozman-Hof Regional Eye Clinic PA
• Boozman-Hof Regional Eye Clinic PA (Boozman-Hof Optical)
• Kelsey Bourdon
• Elizabeth G. Bowden, M.A. CCC-A
• Miranda Nichole Bowen-Perkins, APRN
• Paige Nichole Bowen, FNP
• Sarah Bowen
• Bowers Occupational Therapy Service Inc

• Vascular Surgery Physician in Rogers, AR
• Providers in Rogers, AR by specialty
• Vascular Surgery Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2008; 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.