Abdiel Bourne, OTD

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

121555 Issued in TX

Practice address

2620 Scripture St
Denton, TX 76201-4315

Phone

(940) 297-6500

NPI assigned

Apr 3, 2021

Last updated

Apr 3, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1617408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617408000000",
    "number": "1710566286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8801 QUARRY RIDGE TRL",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762445162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2620 SCRIPTURE ST",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762014315",
            "telephone_number": "940-297-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURNE",
        "first_name": "ABDIEL",
        "name_prefix": "Dr.",
        "credential": "OTD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-04-03",
        "last_updated": "2021-04-03",
        "certification_date": "2021-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "121555",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EXECUTIVE COUNCIL OF PHYSICAL THERAPY AND OCCUPATIONAL THERAPY EXAMINERS",
            "identifier": "121555",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONAL BOARD FOR CERTIFICATION IN OCCUPATIONAL THERAPY",
            "identifier": "446374",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ann Borges
• Megan Nicole Borth
• Susan M Bose, ANP
• Chevelta A Bostick-Smith, DO
• Lesandra Botello, SLP
• Paul Boutwell, MOT, OTR
• Amanda Bova, MT-BC
• Kimberly Bowen, M.S., CCC-SLP
• Jessica Bowers, BCBA
• Darian Boylson

• Occupational Therapist in Denton, TX
• Providers in Denton, TX by specialty
• Occupational Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2021; 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.