NPIMap

Individual provider Active NPI

Nabil Bourjeily, MD

  • Internal Medicine Physician
  • Newark, OH
National Provider Identifier
1740239110
Registry record updated May 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35087383 Issued in OH
Practice address
42 Messimer Dr
Newark, OH 43055-1842
Phone
(740) 522-5641
Fax
(740) 522-5642
NPI assigned
May 10, 2006
Last updated
May 12, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35087383 OH Primary

Addresses

Primary practice location

42 Messimer Dr
Newark, OH 43055-1842

Mailing address

28 S Westmoor Ave Apt E
Newark, OH 43055-1857
Phone (740) 788-9328

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071218000581 SC Practitioner - Internal Medicine 7810908803 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Northeastern Ohio University College of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

300 Singleton Ridge Rd
Conway, SC 29526-9142
Phone (843) 347-7111

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35087383OHMDInternal Medicine Physician
30271SCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital Physician Services - Southeast Professional Corporation CurrentSince Jan 1, 2012 Accepting new patients
Conway Hospital, Inc. Past Accepting new patients

Locations

501 Redmond Rd NW
Rome, GA 30165
Phone (706) 291-0291

300 Singleton Ridge Rd
Conway, SC 29526
Phone (843) 234-6946

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210550400000",
    "number": "1740239110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 S WESTMOOR AVE APT E",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430551857",
            "telephone_number": "740-788-9328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 MESSIMER DR",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430551842",
            "telephone_number": "740-522-5641",
            "fax_number": "740-522-5642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURJEILY",
        "first_name": "NABIL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-10",
        "last_updated": "2008-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35087383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, OH

Sources for this page

Verify at the official NPI Registry.