Individual provider Active NPI

Ashley S Bourne, DC

  • Chiropractor
  • Orange City, FL
National Provider Identifier
1407980980
Registry record updated Jun 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH9261 Issued in FL
Practice address
2425 S Volusia Ave
Suite B-2
Orange City, FL 32763-7625
Phone
(386) 789-0500
Fax
(386) 789-8182
NPI assigned
Mar 15, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH9261 FL Primary

Addresses

Primary practice location

2425 S Volusia Ave
Suite B-2
Orange City, FL 32763-7625

Mailing address

2425 S Volusia Ave
Suite B-2
Orange City, FL 32763-7625
Phone (386) 789-0500

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
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
CH9261FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Complete Wellness Chiropractic Center of Deland LLC Chiropractor PastSince Sep 15, 2010 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213833600000",
    "number": "1407980980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2425 S VOLUSIA AVE",
            "address_2": "SUITE B-2",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327637625",
            "telephone_number": "386-789-0500",
            "fax_number": "386-789-8182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2425 S VOLUSIA AVE",
            "address_2": "SUITE B-2",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327637625",
            "telephone_number": "386-789-0500",
            "fax_number": "386-789-8182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURNE",
        "first_name": "ASHLEY",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-15",
        "last_updated": "2008-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH9261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2008; 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.