BLAKE MICHAEL BOURGOYNE (NPI# 1306306717) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306306717 |
| Entity Type | Individual |
| Full Name | BLAKE MICHAEL BOURGOYNE |
| Practice Address |
5246 Brittany Dr Fl 3 Baton Rouge LA 70808-9136 |
| Practice Telephone | 2257574210 |
| Mailing Telephone | 2257574210 |
| Enumeration Date | 2019-03-21 |
| Last Update Date | 2019-03-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
5246 BRITTANY DR FL 3 |
| City | BATON ROUGE |
| State | LA |
| Zip Code | 70808-9136 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326481268 | John Christopher Michael | Emergency Medicine | 5246 Brittany Dr Fl 3, Baton Rouge, LA 70808-9136 | 2013-04-10 |
| 1295296192 | Vinay Vaz | Student in an Organized Health Care Education/Training Program | 5246 Brittany Dr Fl 3, Baton Rouge, LA 70808-9136 | 2019-03-26 |
| 1548721426 | Hillary Smith | Student in an Organized Health Care Education/Training Program | 5246 Brittany Dr Fl 3, Baton Rouge, LA 70808-9136 | 2019-03-25 |
| 1376003509 | Jennifer Phan | Student in an Organized Health Care Education/Training Program | 5246 Brittany Dr Fl 3, Baton Rouge, LA 70808-9136 | 2019-03-22 |
| 1912467499 | Ana Teresa Garces-wood | Student in an Organized Health Care Education/Training Program | 5246 Brittany Dr Fl 3, Baton Rouge, LA 70808-9136 | 2019-03-21 |
| 1275911554 | Justin Steinberg | Emergency Medicine | 5246 Brittany Dr Fl 3, Baton Rouge, LA 70808-9136 | 2015-05-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790313161 | Leah Michelle Dlugolecki | Student in an Organized Health Care Education/Training Program | Lsu Psychiatry Residency Program, 5246 Brittany Drive, Baton Rouge, LA 70808 | 2020-03-31 |
| 1003376302 | Kristina Pham | Student in an Organized Health Care Education/Training Program | 5246 Brittany Drive, 3rd Floor, Baton Rouge, LA 70808 | 2019-03-22 |
| 1083174486 | John Jay Hogan | Student in an Organized Health Care Education/Training Program | Lsu Emergency Medicine Residency Program, 5246 Brittany Drive, Baton Rouge, LA 70808 | 2019-03-21 |
| 1033682075 | Joseph Bertell Davis Jr. | Case Manager/Care Coordinator | 2460 College Drive, Baton Rouge, LA 70808 | 2019-01-02 |
| 1508340886 | Jennifer Miatech | Student in an Organized Health Care Education/Training Program | 8585 Picardy Ave., Medical Tower 2, Baton Rouge, LA 70808 | 2018-09-21 |
| 1700389137 | Jenee Robins | Case Manager/Care Coordinator | 2100 College Dr Apt 159, Baton Rouge, LA 70808 | 2018-03-12 |
| 1952812893 | Da Vonna Dents | Behavioral Analyst | 418 Stoney Creek Ave, Baton Rouge, LA 70808 | 2017-10-18 |
| 1962925669 | Katharine Elizabeth Blum | Counselor | 7936 Wrenwood Blvd. Ste A, Baton Rouge, LA 70808 | 2017-07-25 |
| 1801316120 | Amie Jackson | Social Worker | 5420 Corporate Blvd. Ste 308, Baton Rouge, LA 70808 | 2017-06-27 |
| 1235660713 | Melissa A Eddy-shelby | Student in an Organized Health Care Education/Training Program | 5000 Hennessy Blvs, Suite 6004, Baton Rouge, LA 70808 | 2017-03-25 |
| Find all providers in zip 70808 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356953160 | Ryne Michael Smith | Student in an Organized Health Care Education/Training Program | 4124 Lake Limestone Ct, Baton Rouge, LA 70816-6409 | 2020-08-21 |
| 1649881251 | Adam Yarochowicz | Student in an Organized Health Care Education/Training Program | 1385 Crescent Dr, Baton Rouge, LA 70806-8612 | 2020-08-17 |
| 1487265021 | Annadora Janet Bruce-keller | Student in an Organized Health Care Education/Training Program | 6324 Morgan Bend Dr, Baton Rouge, LA 70820-2002 | 2020-08-16 |
| 1093324220 | Raghu Rudraraju | Student in an Organized Health Care Education/Training Program | 3401 North Boulevard Baton Rouge General Mid City Medi, Suite 130, Baton Rouge, LA 70806 | 2020-07-23 |
| 1497374847 | Yara Mouawad | Student in an Organized Health Care Education/Training Program | 3401 North Boulevard, Suite 130, Baton Rouge, LA 70806 | 2020-04-15 |
| 1235758939 | Nicole Ashley Lecoq | Student in an Organized Health Care Education/Training Program | 12636 E Sheraton Ave, Baton Rouge, LA 70815-6838 | 2020-04-13 |
| 1396364527 | Sai Samyuktha Bandaru | Student in an Organized Health Care Education/Training Program | Brg Mid City Medicine Clinic, 3401 North Boulevard, Sui, Baton Rouge, LA 70806 | 2020-04-08 |
| 1790313161 | Leah Michelle Dlugolecki | Student in an Organized Health Care Education/Training Program | Lsu Psychiatry Residency Program, 5246 Brittany Drive, Baton Rouge, LA 70808 | 2020-03-31 |
| 1477180487 | Samantha Steve Grigus | Student in an Organized Health Care Education/Training Program | 6224 Belle Grove Dr, Baton Rouge, LA 70820-5020 | 2020-03-27 |
| 1851928147 | Joel Byrne | Student in an Organized Health Care Education/Training Program | 5131 Odonovan Dr Fl 5, Baton Rouge, LA 70808-4791 | 2020-03-25 |
| Find all providers in BATON ROUGE | ||||
| City | BATON ROUGE |
| Zip Code | 70808 |
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| 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.