Active NPI
Daryl Patrick Bourgeois, MS, OTR/L
- Occupational Therapist
- Ayden, NC
National Provider Identifier
1679831143
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 7220
- Practice address
- 554 Second Street
Ayden, NC 28513-7202 - Phone
- (252) 714-8568
- NPI assigned
- May 2, 2012
- Last updated
- May 2, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 7220 | NC | Primary |
Addresses
Primary practice location
554 Second Street
Ayden, NC 28513-7202
Mailing address
104 Berkshire Dr
Winterville, NC 28590-9105
Phone (252) 259-2012
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1335916800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1335916800000",
"number": "1679831143",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "104 BERKSHIRE DR",
"city": "WINTERVILLE",
"state": "NC",
"postal_code": "285909105",
"telephone_number": "252-259-2012"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "554 SECOND STREET",
"city": "AYDEN",
"state": "NC",
"postal_code": "285137202",
"telephone_number": "252-714-8568"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOURGEOIS",
"first_name": "DARYL",
"middle_name": "PATRICK",
"name_prefix": "Mr.",
"credential": "MS, OTR/L",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-05-02",
"last_updated": "2012-05-02",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NC",
"license": "7220",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ayden, NC
- Alexis Nicole Askew, LCMHCA, NCC
- At Home Care Sweetmore Drive
- Gary G Bawtinhimer, M.D.
- Julie Beck
- Bio-Medical Applications of North Carolina, Inc. (Fresenius Medical Care of Ayden)
- Alyssa Grace Bourget, DPT
- Tracey Walston Bowen, MD
- Brenley Paige Boyd, PTA
- Britthaven, Inc. (Britthaven of Ayden)
- Frandrea Latrice Brown, PHD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.