Kimberly Bourque, OTR/L

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Practice address

108A North Main Street
Sunderland, MA 01375-9502

Phone

(413) 665-8717

NPI assigned

Oct 12, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1444608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444608000000",
    "number": "1174994552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28A W CENTER ST",
            "city": "FLORENCE",
            "state": "MA",
            "postal_code": "010621210",
            "telephone_number": "413-320-0140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108A NORTH MAIN STREET",
            "city": "SUNDERLAND",
            "state": "MA",
            "postal_code": "013759502",
            "telephone_number": "413-665-8717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURQUE",
        "first_name": "KIMBERLY",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-12",
        "last_updated": "2015-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John D Boyden, D.C.
• Samantha Lynn Brand, MS, OTR/L
• Mary Anne Bright, EDD, APRN, BC
• Anna Butler
• Pamela Cavanaugh

• Community Health Worker in Sunderland, MA
• Providers in Sunderland, MA by specialty
• Community Health Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2015; 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.