Active NPI
Cynthia Denise Bourbon, RPH
- Pharmacist
- Branson West, MO
National Provider Identifier
1295497782
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 042757
- Practice address
- 106 Silver Thread LN
Branson West, MO 65737-8990 - Phone
- (417) 221-1112
- NPI assigned
- Oct 12, 2021
- Last updated
- Oct 12, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 042757 | MO | Primary |
Addresses
Primary practice location
106 Silver Thread LN
Branson West, MO 65737-8990
Mailing address
106 Silver Thread LN
Branson West, MO 65737-8990
Phone (417) 272-1112
Other names 1
- Cynthia Denise Bourbon
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 042757 | MO | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Locations
106 Silver Thread Ln
Branson West, MO 65737
Phone (417) 221-1112
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1633996800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1633996800000",
"number": "1295497782",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "106 SILVER THREAD LN",
"city": "BRANSON WEST",
"state": "MO",
"postal_code": "657378990",
"telephone_number": "417-272-1112"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "106 SILVER THREAD LN",
"city": "BRANSON WEST",
"state": "MO",
"postal_code": "657378990",
"telephone_number": "417-221-1112"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOURBON",
"first_name": "CYNTHIA",
"middle_name": "DENISE",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-10-12",
"last_updated": "2021-10-12",
"certification_date": "2021-10-12",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MO",
"license": "042757",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "CYNTHIA",
"last_name": "BOURBON",
"middle_name": "DENISE",
"credential": "RPH",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Branson West, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.