Carla Bourelly, APRN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

287303 Issued in GA

Practice address

2591 Candler Rd
Decatur, GA 30032-6502

Phone

(770) 310-8686

NPI assigned

Jul 8, 2011

Last updated

Jul 6, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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 GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1310083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657065600000",
    "number": "1851688097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2591 CANDLER RD",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300326502",
            "telephone_number": "770-310-8686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2591 CANDLER RD",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300326502",
            "telephone_number": "770-310-8686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURELLY",
        "first_name": "CARLA",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-08",
        "last_updated": "2022-07-06",
        "certification_date": "2022-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "287303",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "287303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gary Robert Botstein, M.D.
• John Bouchard
• Yvette Denise Boudoin, ARDMS
• Cheryl Ann Boudreaux, COA
• Latwana J Boughter, R.T.(R)(ARRT)
• Emil Gerald Bousson, COT, CRA, RDMS, ROUB
• Sheila Denise Bousson, COT, CRA
• Adrienne Bouxsein
• Dee Bowbliss, NNP-BC
• Jeronia Bowden, LCSW

• Psychiatric/Mental Health Nurse Practitioner in Decatur, GA
• Providers in Decatur, GA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.