Active NPI
Danielle Bourbina, MA,CCC-SLP
- Speech-Language Pathologist
- Sedalia, MO
National Provider Identifier
1972020501
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 2017010395
- Practice address
- 610 S Engineer Ave
Sedalia, MO 65301-4734 - Phone
- (660) 826-5926
- NPI assigned
- Aug 24, 2017
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 2017010395 | MO | Primary |
Addresses
Primary practice location
610 S Engineer Ave
Sedalia, MO 65301-4734
Mailing address
610 S Engineer Ave
Sedalia, MO 65301-4734
Other names 1
- Miss Danielle Blosser
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)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2017010395 | MO | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1503532800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1540857600000",
"number": "1972020501",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "610 S ENGINEER AVE",
"city": "SEDALIA",
"state": "MO",
"postal_code": "653014734"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "610 S ENGINEER AVE",
"city": "SEDALIA",
"state": "MO",
"postal_code": "653014734",
"telephone_number": "660-826-5926"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOURBINA",
"first_name": "DANIELLE",
"name_prefix": "Ms.",
"credential": "MA,CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-08-24",
"last_updated": "2018-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MO",
"license": "2017010395",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "DANIELLE",
"last_name": "BLOSSER",
"prefix": "MISS",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Sedalia, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.