Christy Bourdlais, NP

Primary specialty

Women's Health Nurse PractitionerTaxonomy code 363LW0102X

License

4704282976 Issued in MI

Practice address

1019 Campus Drive
Big Rapids, MI 49307

Phone

(231) 591-5961

Fax

(231) 591-5970

NPI assigned

Mar 2, 2015

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/17442/brand/2/csg/1/fhir/r4

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.

• Michigan Primary Care Partners P C

  • Internal Medicine Physician
  • Big Rapids, MI
  • NPI 1366497380
  NPD
• Ferris State University

  • Optometrist
  • Big Rapids, MI
  • NPI 1871510859
  NPD (past)

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

{
    "created_epoch": "1425254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484611200000",
    "number": "1225420136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1019 CAMPUS DRIVE",
            "city": "BIG RAPIDS",
            "state": "MI",
            "postal_code": "49307",
            "telephone_number": "231-591-5961",
            "fax_number": "231-591-5970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1019 CAMPUS DRIVE",
            "city": "BIG RAPIDS",
            "state": "MI",
            "postal_code": "49307",
            "telephone_number": "231-591-5961",
            "fax_number": "231-591-5970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURDLAIS",
        "first_name": "CHRISTY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-02",
        "last_updated": "2017-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "MI",
            "license": "4704282976",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bloomfield Chiropractic, LLC
• Bradley Jordan Bloomfield, D.C.
• Rudy R. D. Bogoian III, M.D.
• Emily Joy Bongard, LMSW
• Julie A Boss, DO
• Amanda Grace Bouvrette
• Andrea Bouwknegt
• Dawn Boven, MA, CCC-SLP
• Brooklynn Boyd
• Matthew D Bradley, LLMSW

• All providers in Big Rapids, MI
• Women's Health Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 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.