Jeffrey Bourne D O Medical Corporation

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

20A7050 Issued in CA

Legal business name

JEFFREY BOURNE D O MEDICAL CORPORATION

Practice address

710 Las Canoas PL
Santa Barbara, CA 93105-2362

Phone

(805) 391-3268

Fax

(805) 434-3209

NPI assigned

Sep 21, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Jeffrey Bourne, D.O.NPI 1144325754

Title

President

Phone

(805) 391-3268

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Central Coast Home Health Inc

  • Home Health Agency
  • San Luis Obispo, CA
  • NPI 1609044924

  Operational/Managerial Control

  CMS ownership

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jeffrey Richard Bourne, DO

  • Internal Medicine Physician
  • Santa Barbara, CA
  • NPI 1144325754
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1285027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1556236800000",
    "number": "1235447491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 148",
            "city": "TEMPLETON",
            "state": "CA",
            "postal_code": "934650148",
            "telephone_number": "805-391-3268",
            "fax_number": "805-434-3209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 LAS CANOAS PL",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931052362",
            "telephone_number": "805-391-3268",
            "fax_number": "805-434-3209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFREY BOURNE D O MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-21",
        "last_updated": "2019-04-26",
        "status": "A",
        "authorized_official_last_name": "BOURNE",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "805-391-3268",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "20A7050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Anna Thery Jenkins
• Daniel Jenkins, MD

• Internal Medicine Physician in Santa Barbara, CA
• Providers in Santa Barbara, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.