Christine Caroline Bourgoin, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

9166500 Issued in FL

Practice address

6006 49TH St N Ste 120
Saint Petersburg, FL 33709-2149

Phone

(727) 528-5739

Fax

(727) 528-5855

NPI assigned

Nov 9, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Inova Health Care Services

  • Internal Medicine Physician
  • Falls Church, VA
  • NPI 1952320061
  Medicare reassignment
• Cardiology Consultants

  • Specialist
  • St Petersburg, FL
  • NPI 1811940802
  NPD (past)
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1320796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619481600000",
    "number": "1720365448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6006 49TH ST N STE 120",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337092149",
            "telephone_number": "727-528-5739",
            "fax_number": "727-528-5855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6006 49TH ST N STE 120",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337092149",
            "telephone_number": "727-528-5739",
            "fax_number": "727-528-5855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURGOIN",
        "first_name": "CHRISTINE",
        "middle_name": "CAROLINE",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-09",
        "last_updated": "2021-04-27",
        "certification_date": "2021-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "VA",
            "license": "0001180899",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "9166500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carol Anne Boulay, ARNP
• Joseph Alfred Boulay Jr., M.D.
• Barbara Jean Bour, P.T.
• Mary Paige Bourbeau, ARNP
• Lori Lee Bourgard
• Bryson Bourne
• Laura Ann Bousson, COTA
• Rebecca Bouvier, DNP, FNP-BC
• Zoltan Bouwhuis, BSCPT, CLT
• Monica Cristina Bovee, ATC, LAT, ROT

• Family Nurse Practitioner in Saint Petersburg, FL
• Providers in Saint Petersburg, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.