Katie Bourbonnais, M.S, ATC, LAT, CSCS

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

Practice address

Saint Mary's College
Angela Athletic Facility
Notre Dame, IN 46556

Phone

(574) 284-4006

NPI assigned

Oct 26, 2014

Last updated

Dec 4, 2015By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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

{
    "created_epoch": "1414281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449187200000",
    "number": "1255736849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 E PARK DR",
            "city": "NILES",
            "state": "MI",
            "postal_code": "491205031",
            "telephone_number": "269-362-0897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "SAINT MARY'S COLLEGE",
            "address_2": "ANGELA ATHLETIC FACILITY",
            "city": "NOTRE DAME",
            "state": "IN",
            "postal_code": "46556",
            "telephone_number": "574-284-4006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURBONNAIS",
        "first_name": "KATIE",
        "credential": "M.S, ATC, LAT, CSCS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-26",
        "last_updated": "2015-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Willard Agnew III, MS, ATC
• Julie Bennington, PSYD
• Bethany R. Cohen, M.D.
• Kathryn Marie Cox Cohoon, M.D.
• Chelsey Delgado, FNP-C
• Elizabeth Anne Fourman, M.S.N., N.P.
• Benjamin Garman

• Athletic Trainer in Notre Dame, IN
• Providers in Notre Dame, IN by specialty
• Athletic Trainer in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 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.