Kevin Raymond Bourgeois Jr., DO

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

27785 Issued in MS

Practice address

4500 13TH St
Gulfport, MS 39501-2515

Phone

(228) 865-3151

NPI assigned

Apr 17, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Emergency Medicine

Education

William Carey University College of Osteopathic Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Vincent Emergency Group, LLCGroup PAC ID 0840621926, 43 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Slidell Memorial Hospital Hospital, Slidell, LA, CCN 190040

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kbourgeois1774159@direct.ochsner.org
• Direct secure messaging: kbourgeois@direct.mhg.com

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.

• Vincent Emergency Group, LLC

  • Emergency Medicine Physician
  • Lufkin, TX
  • NPI 1740816917

  LA

  Medicare reassignment Care Compare group NPD
• Belle Chasse Emergency Group LLC

  • Emergency Medicine Physician
  • New Orleans, LA
  • NPI 1851714075
  Medicare reassignment NPD
• Ochsner Clinic LLC

  • General Practice Physician
  • New Orleans, LA
  • NPI 1538151428
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Slidell Memorial Hospital

  • General Acute Care Hospital
  • Slidell, LA
  • NPI 1578568481
  Care Compare affiliation

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

{
    "created_epoch": "1523923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676332800000",
    "number": "1437646239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 13TH ST",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395012515",
            "telephone_number": "228-865-3151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 13TH ST",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395012515",
            "telephone_number": "228-865-3151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURGEOIS",
        "first_name": "KEVIN",
        "middle_name": "RAYMOND",
        "name_suffix": "Jr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-17",
        "last_updated": "2023-02-14",
        "certification_date": "2023-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "LA",
            "license": "325332",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MS",
            "license": "27785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• June Boudreaux, CPSS
• James David Bounds, DDS
• Megan Logan Bounds, MS/CCC-SLP
• Lawrence Paul Bourgeios III, DC
• Chelsea Rae Bourgeois, RDN, LD, MS
• Kimberly Bourgeois
• Ronald S. Bourgeois, DDS
• Aurellia Celeste Bourne, RN, CLC
• Logan Tyler Boutwell, MD
• Caleb Brennan Bowen, DO

• Emergency Medicine Physician in Gulfport, MS
• Providers in Gulfport, MS by specialty
• Emergency Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.