Raven Michelle House-Bourne, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CHIR010628 Issued in GA

Practice address

3512 Highway 155 N Ste A2
McDonough, GA 30252-5506

Phone

(504) 333-9084

NPI assigned

Aug 18, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• 100 Chiro Bourne LLC

  • Chiropractor
  • McDonough, GA
  • NPI 1386362978
  Medicare reassignment NPD Authorized official
• 100 Chiro Anthony 2 LLC

  • Chiropractor
  • McDonough, GA
  • NPI 1912739756
  NPD

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

{
    "created_epoch": "1660780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660780800000",
    "number": "1487372074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 DARTER DR NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301445083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3512 HIGHWAY 155 N STE A2",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302525506",
            "telephone_number": "504-333-9084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOUSE-BOURNE",
        "first_name": "RAVEN",
        "middle_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-18",
        "last_updated": "2022-08-18",
        "certification_date": "2022-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR010628",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "drraven.hb@100percentdoc.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3512 Highway 155 N Ste A2",
            "city": "McDonough",
            "state": "GA",
            "country_code": "US",
            "postal_code": "302525506",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Diana Hope, LMSW, CASAC
• Oliver Hornbuckle
• Takeia Horton, PA-C
• Kira Haja Hoston
• Yvonne Holali Hotor, CRNA
• Megan House, LMT
• How May I Health You
• Brenson Howard
• Rebecca Howard, NP
• Robert Paul Howard, DC

• Chiropractor in McDonough, GA
• Providers in McDonough, GA by specialty
• Chiropractor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.