Bryan Treffley Bourcier, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

05009312A Issued in IN

Practice address

3946 Ice Way
Fort Wayne, IN 46805-1018

Phone

(260) 266-4006

Fax

(260) 266-4008

NPI assigned

Jul 31, 2007

Last updated

Oct 20, 2022By 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 3

Electronic endpoints 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: bbourcier63712@direct.parkviewexchange.com

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

{
    "created_epoch": "1185840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666224000000",
    "number": "1700076213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11130 PAKVIEW CIRCLE DRIVE",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451545",
            "telephone_number": "260-266-7400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3946 ICE WAY",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468051018",
            "telephone_number": "260-266-4006",
            "fax_number": "260-266-4008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURCIER",
        "first_name": "BRYAN",
        "middle_name": "TREFFLEY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-31",
        "last_updated": "2022-10-20",
        "certification_date": "2022-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05009312A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICAID",
            "identifier": "100257920",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE",
            "identifier": "156546",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200880200A",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bbourcier63712@Direct.Parkviewexchange.com",
            "affiliation": "N",
            "address_1": "3946 Ice Way",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468051018",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicprod-mobile.parkview.com/FHIR/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "3946 Ice Way",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468051018",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicprod-mobile.parkview.com/FHIR/api/FHIR/R4/",
            "affiliation": "N",
            "address_1": "3946 Ice Way",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468051018",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Stacey M Boswell, PA
• Vaneska Bottino Da Costa, M.D.
• Sarah Botts, PT, DPT
• Stephanie Botts, MBA, LAT, ACT
• Paige Boughan
• Crystal M Bourcier, DPT
• Kasey M Bourke, MSW, LCSW
• Haylee Bourlier, OD
• Kaitlyn Bouthot, RBT
• Samuel Bow

• Physical Therapist in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Physical Therapist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.