Jeanette Lillian Bourne, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

9300658 Issued in NC

Practice address

16511 Northcross Dr Ste a
Huntersville, NC 28078-5021

Phone

(910) 296-2130

Fax

(704) 896-3313

NPI assigned

Jan 17, 2007

Sex

Female

Sole proprietor

Yes

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 NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family PracticeAlso: Obstetrics/Gynecology

Education

University of Massachusetts Medical School, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pain Clinic of North Carolina PAGroup PAC ID 6406110733, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/22472/brand/1/csg/1/fhir/r4

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.

• Pain Clinic of North Carolina, PA

  • Pain Clinic/Center
  • Huntersville, NC
  • NPI 1538682216
  Medicare reassignment Care Compare group
• Promed Healthcare, PLLC

  • Family Medicine Physician
  • Charlotte, NC
  • NPI 1770615114
  Medicare reassignment NPD
• Promed Healthcare, PLLC

  • Urgent Care Clinic/Center
  • Charlotte, NC
  • NPI 1750572368
  NPD
• County of Duplin

  • State or Local Public Health Clinic/Center
  • Kenansville, NC
  • NPI 1235198177
  NPD (past)
• County of Duplin

  • Land Ambulance
  • Kenansville, NC
  • NPI 1508919069
  NPD (past)

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772668800000",
    "number": "1831241272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2728 EVANS DAIRY RD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283127194",
            "telephone_number": "919-827-7766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16511 NORTHCROSS DR STE A",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280785021",
            "telephone_number": "910-296-2130",
            "fax_number": "704-896-3313"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "601 Martin Luther King Drive",
            "address_2": "Suite 244",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271100001",
            "country_code": "US",
            "telephone_number": "336-750-3300",
            "fax_number": "336-750-3303",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOURNE",
        "first_name": "JEANETTE",
        "middle_name": "LILLIAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-17",
        "last_updated": "2026-03-05",
        "certification_date": "2026-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NC",
            "license": "9300658",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NC",
            "license": "9300658",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Candace Anjanee Boone, FNP-BC
• Sarah Grace Boone, PT, DPT
• Kaylie Booth
• Jason Adrian Boothe, MD
• Jayda Boston
• Ansley Walker Boutin, PT
• Amanda Brooks Bowen, PA-C
• Anastasia Bowman, PT, DPT
• Christian Bowman, SLP
• Elizabeth Ann Boyd, LCMHC

• General Practice Physician in Huntersville, NC
• Providers in Huntersville, NC by specialty
• General Practice Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.