Jayme A Bork, DO

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

41816 Issued in MN

Practice address

Amrtc 3301 7TH Ave N
Anoka, MN 55303

Phone

(218) 340-4308

NPI assigned

Nov 1, 2006

Last updated

Dec 5, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jbork@direct.scf.cc

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.

• Anoka Metro Regional Treatment Center

  • Psychiatric Hospital
  • Anoka, MN
  • NPI 1275585564
  Medicare reassignment NPD
• Alaska Native Tribal Health Consortium

  • General Acute Care Hospital
  • Anchorage, AK
  • NPI 1437189339
  NPD

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575504000000",
    "number": "1649357112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "AMRTC 3301 7TH AVE N",
            "city": "ANOKA",
            "state": "MN",
            "postal_code": "553034516",
            "telephone_number": "218-340-4308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "AMRTC 3301 7TH AVE N",
            "city": "ANOKA",
            "state": "MN",
            "postal_code": "55303",
            "telephone_number": "218-340-4308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORK",
        "first_name": "JAYME",
        "middle_name": "A",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2019-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MN",
            "license": "41816",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "377716200",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Julie Ann Bohlman, PA-C
• Hellen J Boit, APRN, DNP
• Alison Bollman, LCSW
• Shannon Bookwalter, LADC
• Dana Lynn Bork, MS-CCC-SLP
• Boulder Pointe Equestrian & Event Center, LLC
• Jodi Le Bourgoin
• Benjamin Braus, MD
• Joni Karla Britton, MA ED, LICSW
• Frances Hart Broghammer, M.D.

• Psychiatry Physician in Anoka, MN
• Providers in Anoka, MN by specialty
• Psychiatry Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2019; 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.