Amanda Bourne, BS

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

900 N Broadway St
Ste 1
Poteau, OK 74953-2617

Phone

(918) 649-0772

NPI assigned

Jul 30, 2013

Last updated

Jul 30, 2013By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Bachelor of Science

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: amandabourne@tdh.allscriptsdirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Quest Mhsa

  • Community/Behavioral Health Agency
  • Antlers, OK
  • NPI 1174776819
  Medicare reassignment NPD
• Teladoc Health Medical Group, P.a.

  • Family Medicine Physician
  • Lewisville, TX
  • NPI 1245403567

  Mental Health

  NPD

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

{
    "created_epoch": "1375142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375142400000",
    "number": "1881026060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15681 AVIS CIR",
            "city": "SPIRO",
            "state": "OK",
            "postal_code": "749594005",
            "telephone_number": "479-981-0007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 N BROADWAY ST",
            "address_2": "STE 1",
            "city": "POTEAU",
            "state": "OK",
            "postal_code": "749532617",
            "telephone_number": "918-649-0772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURNE",
        "first_name": "AMANDA",
        "credential": "BS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-30",
        "last_updated": "2013-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Morgan Layne Blair, M.S.
• Trinka Blankenship
• Caleb Christopher Blevins
• Amanda Jolene Marie Bolding
• Thomas Bond
• Tammy Ralene Bower, BHRS
• Amber Boyd
• Debra Bradberry
• Brandy Dyer Medical LLC
• Jennifer Branscum

• Mental Health Counselor in Poteau, OK
• Providers in Poteau, OK by specialty
• Mental Health Counselor in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2013; 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.