Graham Ryne Bourne, DMD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

8017 Issued in NE

Practice address

984125 Nebraska Medical Center
Omaha, NE 68198-4125

Phone

(402) 559-5999

NPI assigned

May 23, 2023

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 NE

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

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

{
    "created_epoch": "1684800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718668800000",
    "number": "1447942099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "984125 NEBRASKA MEDICAL CENTER",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681984125",
            "telephone_number": "402-559-5999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "984125 NEBRASKA MEDICAL CENTER",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681984125",
            "telephone_number": "402-559-5999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURNE",
        "first_name": "GRAHAM",
        "middle_name": "RYNE",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-23",
        "last_updated": "2024-06-18",
        "certification_date": "2024-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NE",
            "license": "8017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria Nichole Bourek
• Walda Bourge, PLMHP
• John Timothy Bourke Jr., RP
• Freddilinda Bourn
• Jeremy P Bourn
• Nahla Bourraman, SLP
• Susan J Boust, MD
• Ouphayvanh Boutmahavong
• Alyssa Bouton
• Kelly Bouxsein, BCBA

• Oral and Maxillofacial Surgery (Dentist) in Omaha, NE
• Providers in Omaha, NE by specialty
• Oral and Maxillofacial Surgery (Dentist) in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2024; 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.