Active NPI
Joseph Blake Bourne III
- Pharmacist
- Lutherville, MD
National Provider Identifier
1821873654
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 29390
- Practice address
- 1801 York Rd
Lutherville, MD 21093-5119 - Phone
- (443) 470-4050
- Fax
- (443) 470-4056
- NPI assigned
- Aug 29, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 29390 | MD | Primary |
Addresses
Primary practice location
1801 York Rd
Lutherville, MD 21093-5119
Mailing address
1801 York Rd
Lutherville, MD 21093-5119
Phone (443) 470-4050
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 29390 | MD | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1693267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1693267200000",
"number": "1821873654",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1801 YORK RD",
"city": "LUTHERVILLE",
"state": "MD",
"postal_code": "210935119",
"telephone_number": "443-470-4050",
"fax_number": "443-470-4056"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1801 YORK RD",
"city": "LUTHERVILLE",
"state": "MD",
"postal_code": "210935119",
"telephone_number": "443-470-4050",
"fax_number": "443-470-4056"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOURNE",
"first_name": "JOSEPH",
"middle_name": "BLAKE",
"name_suffix": "III",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-08-29",
"last_updated": "2023-08-29",
"certification_date": "2023-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MD",
"license": "29390",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lutherville, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.