Jennifer C Bourst, DC PA

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH 7986 Issued in FL

Practice address

13750 W Colonial Dr
Suite 318
Winter Garden, FL 34787-4204

Phone

(407) 654-4506

Fax

(407) 654-4506

NPI assigned

Nov 8, 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

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Chiropractic

Education

Life Chiropractic College - West, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Jennifer C Bourst DC PA

  • Chiropractor
  • Winter Garden, FL
  • NPI 1184804577
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204070400000",
    "number": "1952471997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13750 W COLONIAL DR",
            "address_2": "SUITE 318",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347874204",
            "telephone_number": "407-654-4506",
            "fax_number": "407-654-4506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13750 W COLONIAL DR",
            "address_2": "SUITE 318",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347874204",
            "telephone_number": "407-654-4506",
            "fax_number": "407-654-4506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURST",
        "first_name": "JENNIFER",
        "middle_name": "C",
        "credential": "DC PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-08",
        "last_updated": "2008-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH 7986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Winter Garden, FL
• Providers in Winter Garden, FL by specialty
• Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.