Melissa Dawn Bourland, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

18004066A Issued in IN

Practice address

1001 Main St Ste 1
Dyer, IN 46311-1200

Phone

(219) 322-7800

NPI assigned

Aug 15, 2017

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

Enrolled in IN

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Illiana Eyecare Inc

  • Optometrist
  • Cedar Lake, IN
  • NPI 1215040142

  IN, Optometrist

  Medicare reassignment NPD

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

{
    "created_epoch": "1502755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1346766060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 IVY LN",
            "city": "DYER",
            "state": "IN",
            "postal_code": "463111348",
            "telephone_number": "219-381-7208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 MAIN ST STE 1",
            "city": "DYER",
            "state": "IN",
            "postal_code": "463111200",
            "telephone_number": "219-322-7800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13115 Wicker Ave",
            "address_purpose": "LOCATION",
            "city": "Cedar Lake",
            "state": "IN",
            "postal_code": "463037401",
            "country_code": "US",
            "telephone_number": "219-374-7800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOURLAND",
        "first_name": "MELISSA",
        "middle_name": "DAWN",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-15",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18004066A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela Boose, APRN-PMHNP
• James A Borgetti, RPH
• Alyssa Marie Borkowski
• Valerie Boromisa, LCSW
• Jessica Bosques, LCPC
• Seth Bouwer
• Lauren Deann Bouwman, PT, CLT
• Virginia E Bratcher, MS ED
• David Bruce Braunstein, D.O.
• Elizabet Braviere

• All providers in Dyer, IN
• Optometrist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.