Active NPI
Lori Bourgeois, ATC
- Athletic Trainer
- Richmond, KY
National Provider Identifier
1699129635
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT1291
- Practice address
- 1054 Center Dr Ste 1
Richmond, KY 40475-3851 - Phone
- (225) 206-0224
- NPI assigned
- Apr 15, 2016
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | AT1291 | KY | Primary |
Addresses
Primary practice location
1054 Center Dr Ste 1
Richmond, KY 40475-3851
Mailing address
1054 Center Dr Ste 1
Richmond, KY 40475-3851
Phone (225) 206-0224
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AT1291 | KY | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1460678400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1460678400000",
"number": "1699129635",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1054 CENTER DR STE 1",
"city": "RICHMOND",
"state": "KY",
"postal_code": "404753851",
"telephone_number": "225-206-0224"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1054 CENTER DR STE 1",
"city": "RICHMOND",
"state": "KY",
"postal_code": "404753851",
"telephone_number": "225-206-0224"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOURGEOIS",
"first_name": "LORI",
"credential": "ATC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-04-15",
"last_updated": "2016-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "KY",
"license": "AT1291",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Richmond, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.