Individual provider Active NPI

Robert John Bourbonnais, CRNA

  • Certified Registered Nurse Anesthetist
  • Royal Oak, MI
National Provider Identifier
1669517736
Registry record updated Oct 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
6051 Issued in NC
Practice address
3601 W. 13 Mile Rd
Royal Oak, MI 48073-6769
Phone
(248) 898-5000
NPI assigned
Feb 20, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 4704207523 MI
Certified Registered Nurse Anesthetist 367500000X 6051 NC Primary

Addresses

Primary practice location

3601 W. 13 Mile Rd
Royal Oak, MI 48073-6769

Mailing address

3601 W. 13 Mile Rd
Royal Oak, MI 48073-6769
Phone (248) 898-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190108004046 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 1456446160 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2131 S 17TH St
Wilmington, NC 28401-7407
Phone (910) 343-7044

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.22 of 100Reported as group
Quality
100
Promoting interoperability
100
Improvement activities
40
Cost
84.08

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
309922NCMDDriver
6051NCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Charlotte Gastroenterology & Hepatology, PLLC CurrentSince Apr 11, 2022 Accepting new patients
CHS Anesthesia Services Group Inc Anesthesiology CurrentSince Nov 1, 2018 Accepting new patients
Carolina Anesthesia Associates PA Anesthesiology CurrentSince Nov 15, 2021 Accepting new patients
Novant Health New Hanover Regional Medical Center LLC Nurse Anesthetist, Certified Registered CurrentSince Sep 29, 2025 Accepting new patients
Charlotte Gastroenterology & Hepatology, PLLC CurrentSince Jan 1, 2022 Accepting new patients
Novant Health New Hanover Regional Medical Center LLC CurrentSince Sep 29, 2025 Accepting new patients
J. Arthur Dosher Memorial Hospital Current Accepting new patients
Charlotte Gastroenterology & Hepatology, PLLC CurrentSince Jan 1, 2022 Accepting new patients
J. Arthur Dosher Memorial Hospital Current Accepting new patients
Carolina Regional Anesthesia PLLC Anesthesiology CurrentSince Nov 15, 2021 Accepting new patients
Novi Anesthesia Services PLC Anesthesiology Past Accepting new patients

Locations

1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791

2015 Randolph Rd
Ste 101
Charlotte, NC 28207
Phone (704) 602-6544

15830 Ballantyne Medical Pl
Ste 175
Charlotte, NC 28277
Phone (704) 323-7633

2015 Randolph Rd
Ste 208
Charlotte, NC 28207
Phone (704) 602-6544

3312 Battleground Ave
Greensboro, NC 27410
Phone (336) 282-5000

242A 9th Avenue Dr NE
Hickory, NC 28601
Phone (828) 327-6673

13808 Professional Center Dr
Huntersville, NC 28078
Phone (704) 717-5549

924 N Howe St
Southport, NC 28461
Phone (910) 457-3800

821 N Atlantic Ave
Southport, NC 28461
Phone (910) 457-3827

5115 Oleander Dr
Wilmington, NC 28403
Phone (910) 362-1011

105 Scotts Hill Medical Dr
Wilmington, NC 28411
Phone (910) 686-2840

2131 S 17th St
Wilmington, NC 28401
Phone (910) 342-3000

Organizations & group practices 11

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759881600000",
    "number": "1669517736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3601 W. 13 MILE RD",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480736769",
            "telephone_number": "248-898-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 W. 13 MILE RD",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480736769",
            "telephone_number": "248-898-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURBONNAIS",
        "first_name": "ROBERT",
        "middle_name": "JOHN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-20",
        "last_updated": "2025-10-08",
        "certification_date": "2025-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704207523",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "6051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Royal Oak, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.