Randolph Bourne, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

MD00047603 Issued in WA

Practice address

21616 76TH Ave W Ste 205
Edmonds, WA 98026-7512

Phone

(425) 640-4810

Fax

(425) 640-4884

NPI assigned

Feb 12, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Obstetrics/Gynecology

Education

Vanderbilt University School of Medicine, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Swedish Health ServicesGroup PAC ID 0244138196, 1,038 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Swedish Edmonds Hospital Hospital, Edmonds, WA, CCN 500026

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: randolph.bourne.1@13077.direct.athenahealth.com
• Direct secure messaging: rbourne1041179@wm.providencedirect.org

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

• Swedish Health Services

  • Internal Medicine Physician
  • Seattle, WA
  • NPI 1689612954

  Obstetrics & Gynecology

  Medicare reassignment Care Compare group NPD
• Obhg Washington, PC

  • Obstetrics & Gynecology Physician
  • Silverdale, WA
  • NPI 1962729525
  Medicare reassignment NPD
• Providence Health & Services-Wa

  • General Acute Care Hospital
  • Everett, WA
  • NPI 1700037801
  NPD (past)
• Swedish Edmonds

  • General Acute Care Hospital
  • Edmonds, WA
  • NPI 1033107214
  NPD (past)
• Swedish Health Services

  • Surgery Physician
  • Seattle, WA
  • NPI 1053368571
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Swedish Edmonds

  • General Acute Care Hospital
  • Edmonds, WA
  • NPI 1033107214
  Care Compare affiliation
• Swedish Edmonds

  • Clinical Medical Laboratory
  • Edmonds, WA
  • NPI 1699894022

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191974400000",
    "number": "1881735736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21616 76TH AVE W STE 205",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980267512",
            "telephone_number": "425-640-4810",
            "fax_number": "425-640-4998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21616 76TH AVE W STE 205",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980267512",
            "telephone_number": "425-640-4810",
            "fax_number": "425-640-4884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURNE",
        "first_name": "RANDOLPH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-12",
        "last_updated": "2007-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "WA",
            "license": "MD00047603",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8483646",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robyn Boone, LMP
• Sandra Borg, M.D.
• Raul Borromeo, MD
• Ella Yepraksia Bostanjian, M.D.
• Ann Bourey, PT
• Brianne Marie Bowen, PA-C
• Bowers Family Chiropractic
• Gregory Bowers, D.C.
• Jeffry David Bowers, D.C.
• Susan Amy Bowman, LMP

• Obstetrics & Gynecology Physician in Edmonds, WA
• Providers in Edmonds, WA by specialty
• Obstetrics & Gynecology Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2007; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.