DR. MICHAEL RAY BOURNE (NPI# 1164412649) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164412649 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL RAY BOURNE |
| Credential | MD |
| Practice Address |
1500 Curve Crest Blvd W Stillwater MN 55082 |
| Mailing Address |
8170 33rd Ave S Minneapolis MN 55425-4516 |
| Practice Telephone | 6514391234 |
| Practice Fax Number | 6514391547 |
| Mailing Telephone | 6514391234 |
| Enumeration Date | 2005-10-25 |
| Last Update Date | 2019-05-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 213E00000X | Podiatrist | 746 | WI | Podiatric Medicine & Surgery Service Providers |
| Y | 213E00000X | Podiatrist | 445 | MN | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 43222300 | 05 | |
| MN | 164225100 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710546965 | Michael William Bourne | Internal Medicine | The Gw Medical Faculty Associates, 2150 Pennsylvania Avenue, Nw, Washington, DC 20037 | 2019-06-11 |
| 1992178347 | Michael Bourne | Social Worker | 3415 Se Powell Blvd, Portland, OR 97202-3371 | 2015-11-06 |
| 1881030443 | Michael Hal Bourne Jr. | Internal Medicine | 9427 Sw Barnes Rd Ste 296, Portland, OR 97225-6667 | 2013-05-22 |
| 1073505582 | Michael H Bourne | Orthopaedic Surgery | 1160 E 3900 S Ste 5000, Salt Lake City, UT 84124-1275 | 2005-08-19 |
| Street Address |
1500 CURVE CREST BLVD W |
| City | STILLWATER |
| State | MN |
| Zip Code | 55082 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417951021 | Thomas L Zurbriggen | Internal Medicine | 1500 Curve Crest Blvd W, Stillwater, MN 55082-6040 | 2005-06-10 |
| 1619502168 | Jjel,llc | Pharmacy | 1500 Curve Crest Blvd W, Stillwater, MN 55082-6040 | 2020-03-05 |
| 1689232183 | Kaytlin Hanson | Speech-Language Pathologist | 1500 Curve Crest Blvd W, Stillwater, MN 55082-6040 | 2019-05-31 |
| 1891278347 | Jennifer Lynn Brakke | Nurse Practitioner | 1500 Curve Crest Blvd W, Stillwater, MN 55082-6040 | 2018-09-11 |
| 1598246704 | Jennifer Burandt | Speech-Language Pathologist | 1500 Curve Crest Blvd W, Stillwater, MN 55082 | 2018-08-25 |
| 1083194211 | Sarah Grace Kirvida | Occupational Therapist | 1500 Curve Crest Blvd W, Stillwater, MN 55082 | 2018-08-16 |
| 1578040127 | Emily Marie Donahue | Physical Therapist | 1500 Curve Crest Blvd W, Stillwater, MN 55082-6040 | 2018-07-26 |
| 1003311457 | Park Nicollet Health Care Products | Durable Medical Equipment & Medical Supplies | 1500 Curve Crest Blvd W, Stillwater, MN 55082-6040 | 2018-03-28 |
| 1841711298 | Joanna Beth Hanlon | Registered Nurse | 1500 Curve Crest Blvd W, Stillwater, MN 55082-6040 | 2017-07-06 |
| 1871029116 | David Carl Hess | Internal Medicine | 1500 Curve Crest Blvd W, Stillwater, MN 55082-6040 | 2017-05-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154947455 | Lucas William Schmidt | Optometrist | 2950 Curve Crest Blvd, Stillwater, Stillwater, MN 55082 | 2020-06-23 |
| 1982238085 | Jerald Haley | Technician | 924 6th Ave. S., Stillwater, MN 55082 | 2020-02-27 |
| 1801457387 | Sun Trad Chin Acu Mn LLC | Acupuncturist | Compass Center for Healing, 116 Chestnut St. E., Stillwater, MN 55082 | 2019-06-25 |
| 1598243990 | Carlson Distinctive Dentistry, Pllc | Dentist | 1701 Curve Crest Blvd W Ste 100, Stillwater, MN 55082 | 2018-07-30 |
| 1073001624 | Lindsay Beth Briggs | Chiropractor | 200 Chestnut St E, Ste 202, Stillwater, MN 55082 | 2018-04-30 |
| 1578932943 | Group Health Plan, Inc | Family Medicine | 921 Greeley Street, Stillwater, MN 55082 | 2015-09-16 |
| 1184001919 | Grant Rohrig | Specialist/Technologist | 8727 Jeffrey Ave North, Stillwater, MN 55082 | 2015-04-30 |
| 1346688991 | Kellie Ann Seth | Chiropractor | 200 Chestnut St E Ste 202, Stillwater, MN 55082 | 2013-06-05 |
| 1770928426 | Rivertown Animal Hospital | Veterinarian | 135 New England Place, Stillwater, MN 55082 | 2013-05-08 |
| 1285929265 | Healtheast Medical Research Institute | Dietitian, Registered | 2900 Curve Crest Blvd, Stillwater, MN 55082 | 2011-06-17 |
| Find all providers in zip 55082 | ||||
| Taxonomy Code | 213E00000X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033210851 | Robert Anton Crotty | Podiatrist | 120 N Perkins Rd, Ste A, Stillwater, OK 74075 | 2006-09-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912556937 | Seniorwell Pod of Minnesota, LLC | Podiatrist | 100 S 5th St Ste 1900, Minneapolis, MN 55402-1267 | 2019-09-11 |
| 1033553789 | Advanced Foot & Ankle Clinic LLP | Podiatrist | 633 1st St Se Ste 100, Faribault, MN 55021-6348 | 2013-04-24 |
| 1881963239 | Foot Care Across America, LLC | Podiatrist | 14654 Rhinestone Terrace, Ramsey, MN 55303-4923 | 2011-12-14 |
| 1083902126 | Paul H Peterson | Podiatrist | 1420 109th Ave Ne Ste 100, Blaine, MN 55449-3603 | 2011-07-11 |
| 1619261708 | Nathan D Sanders | Podiatrist | 404 West Fountain Street, Albert Lea, MN 56007-3920 | 2011-06-06 |
| 1427352087 | Doctors By Your Side | Podiatrist | 6600 Lyndale Av S, #120, Richfield, MN 55423-3398 | 2010-12-22 |
| 1154566396 | Sarah Phelps Whittaker | Podiatrist | 2221 Ford Parkway, Suite #350, Saint Paul, MN 55116-3837 | 2008-12-02 |
| 1568635969 | Bolcer Podiatry, Inc. | Podiatrist | 19230 Evans St Nw Ste 109, Elk River, MN 55330-1079 | 2008-04-07 |
| 1194846782 | Range Podiatric Care, Pa | Podiatrist | 809 N 6th Ave, Northgate Plaza, Virginia, MN 55792-2308 | 2007-04-02 |
| 1285779991 | John Tyler Garner | Podiatrist | 2302 Highway 53, Eveleth, MN 55734-8523 | 2007-02-20 |
| Find all providers with the same taxonomy | ||||
| City | STILLWATER |
| Zip Code | 55082 |
Please comment or provide details below to improve the information on DR. MICHAEL RAY BOURNE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.