Mary Paige Bourbeau, ARNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

9253468 Issued in FL

Practice address

5500 9TH St N.
St Petersburg, FL 33703

Phone

(727) 322-1054

Fax

(727) 821-7213

NPI assigned

Mar 7, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/EIJHAA

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.

• Professional Health Care of Pinellas LLC

  • Internal Medicine Physician
  • St Petersburg, FL
  • NPI 1881647253
  Medicare reassignment NPD
• Professional Health Care of Pinellas Inc.

  • Chiropractor
  • St Petersburg, FL
  • NPI 1568970903
  NPD

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

{
    "created_epoch": "1362614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511308800000",
    "number": "1255672796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1839 CENTRAL AVE",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337138900",
            "telephone_number": "727-322-1054",
            "fax_number": "727-821-7213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 9TH ST N.",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "33703",
            "telephone_number": "727-322-1054",
            "fax_number": "727-821-7213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURBEAU",
        "first_name": "MARY",
        "middle_name": "PAIGE",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-03-07",
        "last_updated": "2017-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP 9253468",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "9253468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Lynn Boudreau, MOTR/L
• Amanda Dendis Boudreaux, MD
• Carol Anne Boulay, ARNP
• Joseph Alfred Boulay Jr., M.D.
• Barbara Jean Bour, P.T.
• Lori Lee Bourgard
• Christine Caroline Bourgoin, FNP
• Bryson Bourne
• Laura Ann Bousson, COTA
• Rebecca Bouvier, DNP, FNP-BC

• Family Nurse Practitioner in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 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.