Active NPI
Edward Luke Bourke Jr., MD
- Gastroenterology Physician
- Kailua, HI
National Provider Identifier
1851625479
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- MD2463
- Practice address
- 322 Aoloa St Apt 1305
Kailua, HI 96734-3019 - Phone
- (808) 261-2992
- NPI assigned
- Sep 29, 2009
- Last updated
- Sep 29, 2009
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | MD2463 | HI | Primary |
Addresses
Primary practice location
322 Aoloa St Apt 1305
Kailua, HI 96734-3019
Mailing address
322 Aoloa St Apt 1305
Kailua, HI 96734-3019
Phone (808) 261-2992
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD2463 | HI | MD | Gastroenterology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1254182400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1254182400000",
"number": "1851625479",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "322 AOLOA ST APT 1305",
"city": "KAILUA",
"state": "HI",
"postal_code": "967343019",
"telephone_number": "808-261-2992"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "322 AOLOA ST APT 1305",
"city": "KAILUA",
"state": "HI",
"postal_code": "967343019",
"telephone_number": "808-261-2992"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOURKE",
"first_name": "EDWARD",
"middle_name": "LUKE",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-09-29",
"last_updated": "2009-09-29",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "HI",
"license": "MD2463",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kailua, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.