Active NPI
Laurence Fenn Bourland Jr., D.C.
- Chiropractor
- Hillsboro, OR
National Provider Identifier
1851425821
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 27 1194
- Practice address
- 1623 SE Enterprise Cir
Hillsboro, OR 97123-5064 - Phone
- (503) 640-2614
- Fax
- (503) 648-2637
- NPI assigned
- Mar 14, 2007
- 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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 27 1194 | OR | Primary |
Addresses
Primary practice location
1623 SE Enterprise Cir
Hillsboro, OR 97123-5064
Mailing address
1623 SE Enterprise Cir
Hillsboro, OR 97123-5064
Phone (503) 640-2614
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 17032 | Other | OR | STATE WORKER COMPENSATION |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1194 | OR | MD | Clinical Social Worker |
| 27 1194 | OR | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173830400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1285286400000",
"number": "1851425821",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1623 SE ENTERPRISE CIR",
"city": "HILLSBORO",
"state": "OR",
"postal_code": "971235064",
"telephone_number": "503-640-2614",
"fax_number": "503-648-2637"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1623 SE ENTERPRISE CIR",
"city": "HILLSBORO",
"state": "OR",
"postal_code": "971235064",
"telephone_number": "503-640-2614",
"fax_number": "503-648-2637"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOURLAND",
"first_name": "LAURENCE",
"middle_name": "FENN",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-14",
"last_updated": "2010-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "OR",
"license": "27 1194",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE WORKER COMPENSATION",
"identifier": "17032",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hillsboro, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.