Andrei Petrovich Bourdeinyi, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CHIR006547 Issued in GA

Practice address

3155 Roswell Rd NE
Suite 140
Atlanta, GA 30305-1821

Phone

(404) 231-1000

Fax

(404) 231-5546

NPI assigned

Oct 28, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1161993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972689347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1625 ROSWELL RD",
            "address_2": "APT.138",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300623682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3155 ROSWELL RD NE",
            "address_2": "SUITE 140",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303051821",
            "telephone_number": "404-231-1000",
            "fax_number": "404-231-5546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURDEINYI",
        "first_name": "ANDREI",
        "middle_name": "PETROVICH",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR006547",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11303651",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA INSURANCE COMPANY",
            "identifier": "7467540",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE INS.CO",
            "identifier": "649113",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emerson Bouldin
• Briana Jewel Boulin
• Nicholas M Boulis, MD
• Gary F Bouloux, MD, DDS
• Viktor Bouquette, M.D.
• Denise Dorothy Bourg, PT
• Kristin Bourg, PA
• Debra Bourgeois, CCC-SLP
• Caitlin Adrianna Bourland, APC
• Camryn Vega Bourne

• Chiropractor in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Chiropractor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.