William E, Bourgeois O.D,, S.C.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1571 Issued in WI

Legal business name

WILLIAM E, BOURGEOIS O.D,, S.C.

Practice address

1507 Main St
Marinette, WI 54143-1301

Phone

(715) 735-9593

NPI assigned

Nov 13, 2006

Last updated

Oct 9, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Crystal Sue Herbst

Title

Cpoa

Phone

(715) 735-9593

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI2 enrollments

Enrollment records 2

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• William E Bourgeois, O.D.

  • Optometrist
  • Marinette, WI
  • NPI 1790856334
  Medicare reassignment Care Compare group NPD
• Alex J Schoen, OD

  • Optometrist
  • Marinette, WI
  • NPI 1780336057
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602201600000",
    "number": "1851462394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1507 MAIN ST",
            "city": "MARINETTE",
            "state": "WI",
            "postal_code": "541431301",
            "telephone_number": "715-735-9593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1507 MAIN ST",
            "city": "MARINETTE",
            "state": "WI",
            "postal_code": "541431301",
            "telephone_number": "715-735-9593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAM E, BOURGEOIS O.D,, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-13",
        "last_updated": "2020-10-09",
        "certification_date": "2020-10-09",
        "status": "A",
        "authorized_official_last_name": "HERBST",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "CPOA",
        "authorized_official_telephone_number": "715-735-9593"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "WI",
            "license": "1571",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADMINISTAR",
            "identifier": "022713001",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Juliane Sue Washburn, RD
• Deanna Wauters, LMT
• Mark D Weissman, M.D.
• Jonathan Weseman, MD
• Olena V Wiedemeier, APNP
• Wisconsin Upper Peninsula Oncology Management Services, Inc.
• Krystal K Wolfe, BC HIS
• Linda M Wranik, CSAC
• Wright & Filippis, Inc
• Wright & Filippis, Inc.

• Optometrist in Marinette, WI
• Providers in Marinette, WI by specialty
• Optometrist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.