Phillip Harrigan Bourne, M.D.
Individual provider Active NPI Obstetrics & Gynecology Physician · Nashville, TN
NPI 1427036748 · NPPES record last updated Oct 29, 2018
Key facts
- NPI
- 1427036748
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Obstetrics & Gynecology Physician 207V00000X
- License
- 12507 (TN)
- Practice address
- 1005 Dr. D. B. Todd Blvd
Nashville, TN 37208 - Phone
- (615) 327-5524
- Fax
- (615) 327-5541
- NPI assigned
- Jan 6, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060109000817 | TN | Practitioner - Obstetrics/Gynecology | 0042233751 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12507 | TN | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Meharry Medical College | Current |
Accepting new patients |
Locations
1005 Dr Db Todd Jr Blvd
Nashville, TN 37208
Phone (615) 327-6000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 12507 | TN | Yes |
Addresses
Primary practice location
1005 Dr. D. B. Todd Blvd
Nashville, TN 37208
Mailing address
1005 Dr DB Todd Jr Blvd
Nashville, TN 37208-3501
Phone (615) 327-5944
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3181054 | Medicaid | TN |
Other providers in Nashville, TN
- Paul McCracken Bourdillon
- Jacob Robert Bourgeois
- Kassem Bourgi
- Patrick Joseph Bourke IV
- Lou Allyn Bourn
- Dimyana Nashat Boushra
- Ketsana Bouttavong
- Kelsey Anne Bouwman
- Sandra D Bova
- Tatiana Bovgirya
All providers in Nashville, TN · Obstetrics & Gynecology Physician in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 29, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.