Eric Bornemann, RN, CPNP-PC

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

17935 Issued in TN

Practice address

1318 University Ave
Sewanee, TN 37375-2336

Phone

(931) 598-9761

NPI assigned

Oct 10, 2013

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: eric.bornemann.1@19363.direct.athenahealth.com

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.

• Amg-Southern Tennessee LLC

  • General Practice Physician
  • Winchester, TN
  • NPI 1164789467
  Medicare reassignment NPD
• Amg-Southern Tennessee LLC

  • Rural Health Clinic/Center
  • Tullahoma, TN
  • NPI 1174365803
  NPD
• Amg -Southern Tennessee LLC

  • Internal Medicine Physician
  • Monteagle, TN
  • NPI 1699792390
  NPD (past)
• Amg-Southern Tennessee LLC

  • Rural Health Clinic/Center
  • Sewanee, TN
  • NPI 1770284119
  NPD (past)

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

{
    "created_epoch": "1381363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381363200000",
    "number": "1972930733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 WALNUT ST",
            "address_2": "APT. 205",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374031134",
            "telephone_number": "617-279-9202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1318 UNIVERSITY AVE",
            "city": "SEWANEE",
            "state": "TN",
            "postal_code": "373752336",
            "telephone_number": "931-598-9761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORNEMANN",
        "first_name": "ERIC",
        "credential": "RN, CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-10-10",
        "last_updated": "2013-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TN",
            "license": "17935",
            "primary": true
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MA",
            "license": "RN2281187",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jade M Barry, RDN, LDN
• Julie A Bean, PT
• Bennett Bridgers-Carlos
• James Q Bennett, LCSW
• Craig L Berger, MD
• Jonathan Buffington, LCSW, LADAC II
• David McCrary Burnett, LADAC
• Andrew Bert Carlsen, MD
• Ashish K Chakravarthy, MD
• Compassionate Home Care & Staffing

• Pediatric Nurse Practitioner in Sewanee, TN
• Providers in Sewanee, TN by specialty
• Pediatric Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2013; 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.