Angelique N McKinney-Bourne, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD 418042 Issued in PA

Practice address

5400 Chambers Hill Rd
Harrisburg, PA 17111-2545

Phone

(717) 564-5400

Fax

(717) 564-7859

NPI assigned

Sep 15, 2006

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

Other identifiers 7

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in PA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: angelique.mckinneybourne@398008301912068.direct.elationemr.com

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.

• Pinnacle Health Medical Services

  • Family Medicine Physician
  • Harrisburg, PA
  • NPI 1932143427
  Medicare reassignment NPD
• Pinnacle Health Medical Services

  dba STRENGTH Maternal Addiction Program

  • Obstetrics & Gynecology Physician
  • Harrisburg, PA
  • NPI 1801364039
  NPD
• Premier Medical & Rehabilitation Center, P.C.

  • Rehabilitation Chiropractor
  • Camp Hill, PA
  • NPI 1982867396
  NPD (past)

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655337600000",
    "number": "1942306162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5400 CHAMBERS HILL RD",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171112545",
            "telephone_number": "717-564-5400",
            "fax_number": "717-564-7859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5400 CHAMBERS HILL RD",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171112545",
            "telephone_number": "717-564-5400",
            "fax_number": "717-564-7859"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3045 Marietta Ave",
            "address_purpose": "LOCATION",
            "city": "Lancaster",
            "state": "PA",
            "postal_code": "176011321",
            "country_code": "US",
            "telephone_number": "717-207-4800",
            "fax_number": "717-609-8840",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1251 E Main St",
            "address_purpose": "LOCATION",
            "city": "Annville",
            "state": "PA",
            "postal_code": "170031643",
            "country_code": "US",
            "telephone_number": "717-988-0531",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "320 Market St Ste 165",
            "address_purpose": "LOCATION",
            "city": "Harrisburg",
            "state": "PA",
            "postal_code": "171012225",
            "country_code": "US",
            "telephone_number": "717-988-9330",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2030 Thistle Hill Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Spring Grove",
            "state": "PA",
            "postal_code": "173621160",
            "country_code": "US",
            "telephone_number": "717-207-4800",
            "fax_number": "717-609-8840",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCKINNEY-BOURNE",
        "first_name": "ANGELIQUE",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-15",
        "last_updated": "2022-06-16",
        "certification_date": "2022-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD 418042",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7615520",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH AMERICA",
            "identifier": "1148101",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK PPO",
            "identifier": "2147159",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "271003587",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CD EAST FAMILY HEALTH & WLLNS. CTR. GROUP NPI",
            "identifier": "1710213236",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK MEDICARE",
            "identifier": "177237",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "50091367",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amckinneybourne93130@phsdirect.pinnaclehealth.org",
            "affiliation": "N",
            "address_1": "5400 Chambers Hill Rd",
            "city": "Harrisburg",
            "state": "PA",
            "country_code": "US",
            "postal_code": "171112545",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Deborah R McHugh, CRNP
• Rekha McHugh
• Margaret McKee
• Keri A McKeever, BA
• Heather McKeithan Woerthwein, OT
• Carmen McKinney, MSW, LCSW
• Amanda M McLaughlin, CRNP
• John Patrick McLaughlin, D.O.
• Julia Ann McLaughlin, PA-C
• M Alan McLin, OD

• Family Medicine Physician in Harrisburg, PA
• Providers in Harrisburg, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 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.