Active NPI
John Elliot Bourgeois, MD
- Ophthalmology Physician
- Charlotte, NC
National Provider Identifier
1942258991
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 25883
- Practice address
- 6035 Fairview Rd
Charlotte, NC 28210-3256 - Phone
- (704) 295-3000
- Fax
- (704) 295-3121
- NPI assigned
- May 4, 2006
- Last updated
- Oct 16, 2015
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 25883 | NC | Primary |
Addresses
Primary practice location
6035 Fairview Rd
Charlotte, NC 28210-3256
Mailing address
6035 Fairview Rd
Charlotte, NC 28210-3256
Phone (704) 295-3000
Other identifiers 21
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0841480 | Other | NC | UNITED HEALTHCARE |
| 141004 | Other | NC | COVENTRY |
| 1533931002 | Other | NC | CIGNA |
| N25883 | Medicaid | SC | |
| 100706 | Other | NC | WELLNESS |
| 8917059 | Medicaid | NC | |
| 10610 | Other | NC | BCBS MEDPOINT |
| 11125 | Other | NC | WELLPATH |
| 17059 | Other | NC | BCBS |
| 180019848 | Other | RAILROAD MEDICARE | |
| 6872 | Other | NC | PARTNERS |
| 80783 | Other | SC | CHCCARES OF SC |
| 20094032 | Other | SC | SELECT HEALTH OF SC/FIRST CHOICE |
| 1533931002 | Other | NC | CIGNA PRIMEVISION |
| 000000282479 | Other | SC | UNISON HEALTH PLAN OF SC |
| 21170 | Other | NC | MEDCOST |
| 777013 | Other | SC | WELLCARE |
| 376565 | Other | NC | MAMSI |
| 1963 | Other | NC | DOCTORS HEALTH PLAN |
| 10482 | Other | NC | KANAWHA |
| 4068491 | Other | NC | AETNA |
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)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146700800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1444953600000",
"number": "1942258991",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6035 FAIRVIEW RD",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282103256",
"telephone_number": "704-295-3000",
"fax_number": "704-295-3121"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6035 FAIRVIEW RD",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282103256",
"telephone_number": "704-295-3000",
"fax_number": "704-295-3121"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOURGEOIS",
"first_name": "JOHN",
"middle_name": "ELLIOT",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-04",
"last_updated": "2015-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "NC",
"license": "25883",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "0841480",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COVENTRY",
"identifier": "141004",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "1533931002",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "N25883",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLNESS",
"identifier": "100706",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8917059",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS MEDPOINT",
"identifier": "10610",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLPATH",
"identifier": "11125",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "17059",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "180019848",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PARTNERS",
"identifier": "6872",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHCCARES OF SC",
"identifier": "80783",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SELECT HEALTH OF SC/FIRST CHOICE",
"identifier": "20094032",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA PRIMEVISION",
"identifier": "1533931002",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNISON HEALTH PLAN OF SC",
"identifier": "000000282479",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDCOST",
"identifier": "21170",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLCARE",
"identifier": "777013",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAMSI",
"identifier": "376565",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DOCTORS HEALTH PLAN",
"identifier": "1963",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KANAWHA",
"identifier": "10482",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4068491",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.