Chelsea Rae Bourgeois, RDN, LD, MS

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

D1708 Issued in MS

Practice address

4500 13TH St
Gulfport, MS 39501-2515

Phone

(228) 867-4122

NPI assigned

Nov 21, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1542758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542758400000",
    "number": "1740759547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "606 BEYER DR",
            "city": "BAY SAINT LOUIS",
            "state": "MS",
            "postal_code": "395202802",
            "telephone_number": "813-784-5754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 13TH ST",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395012515",
            "telephone_number": "228-867-4122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURGEOIS",
        "first_name": "CHELSEA",
        "middle_name": "RAE",
        "credential": "RDN, LD, MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-21",
        "last_updated": "2018-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MS",
            "license": "D1708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jerry Paul Boudreaux, L C S W
• June Boudreaux, CPSS
• James David Bounds, DDS
• Megan Logan Bounds, MS/CCC-SLP
• Lawrence Paul Bourgeios III, DC
• Kevin Raymond Bourgeois Jr., DO
• Kimberly Bourgeois
• Ronald S. Bourgeois, DDS
• Aurellia Celeste Bourne, RN, CLC
• Logan Tyler Boutwell, MD

• Registered Dietitian in Gulfport, MS
• Providers in Gulfport, MS by specialty
• Registered Dietitian in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2018; 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.