Active NPI
Angela D Bourne, PT
- Physical Therapist
- Frisco, TX
National Provider Identifier
1386307395
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1133460
- Practice address
- 2873 Hidden Knoll TRL
Frisco, TX 75034-4667 - Phone
- (903) 276-0488
- NPI assigned
- Oct 17, 2021
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1133460 | TX | Primary |
Addresses
Primary practice location
2873 Hidden Knoll TRL
Frisco, TX 75034-4667
Mailing address
2873 Hidden Knoll TRL
Frisco, TX 75034-4667
Phone (903) 276-0488
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | angbourne@outlook.com | Direct |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1133460 | TX | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1634428800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1634428800000",
"number": "1386307395",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2873 HIDDEN KNOLL TRL",
"city": "FRISCO",
"state": "TX",
"postal_code": "750344667",
"telephone_number": "903-276-0488"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2873 HIDDEN KNOLL TRL",
"city": "FRISCO",
"state": "TX",
"postal_code": "750344667",
"telephone_number": "903-276-0488"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOURNE",
"first_name": "ANGELA",
"middle_name": "D",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-10-17",
"last_updated": "2021-10-17",
"certification_date": "2021-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "1133460",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "angbourne@outlook.com",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "2873 Hidden Knoll Trl",
"city": "Frisco",
"state": "TX",
"country_code": "US",
"postal_code": "750344667",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Frisco, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 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.