ADAM LABREE BOURGON (NPI# 1659638575) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659638575 |
| Entity Type | Individual |
| Full Name | ADAM LABREE BOURGON |
| Credential | DO |
| Practice Address |
633d Medical Group 77 Nealy Ave Joint Base Langley-eustis VA 23665-2040 |
| Practice Telephone | (757) 225-4263 |
| Mailing Telephone | (757) 225-4263 |
| Enumeration Date | 2012-04-17 |
| Last Update Date | 2017-08-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | 02004369A | IN | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
633D MEDICAL GROUP 77 NEALY AVE |
| City | JOINT BASE LANGLEY-EUSTIS |
| State | VA |
| Zip Code | 23665-2040 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881688877 | James F Forrest | Optometrist | 633d Medical Group, 77 Nealy Avenue, Joint Base Langley-eustis, VA 23665-2040 | 2005-09-06 |
| 1497213573 | Diana Elise Strain | Social Worker | 633d Medical Group, 77 Nealy Avenue, Joint Base Langley-eustis, VA 23665-2040 | 2019-03-07 |
| 1457865131 | Mary Iskarous | Psychologist | 633d Medical Group, 77 Nealy Avenue, Joint Base Langley-eustis, VA 23665-2040 | 2017-11-17 |
| 1295112977 | Nicholas William Deangelis | Pediatrics | 633d Medical Group, 77 Nealy Avenue, Joint Base Langley-eustis, VA 23665-2040 | 2015-04-30 |
| 1366839961 | Brent Sager | Obstetrics & Gynecology | 633d Medical Group, 77 Nealy Avenue, Joint Base Langley-eustis, VA 23665-2040 | 2015-04-21 |
| 1326459652 | Keith Duron | Dental Hygienist | 633d Medical Group, 77 Nealy Avenue, Joint Base Langley-eustis, VA 23665-2040 | 2014-05-08 |
| 1578998522 | Kristen Ashley Block | Physician Assistant | 633d Medical Group, 77 Nealy Avenue, Joint Base Langley-eustis, VA 23665-2040 | 2013-09-10 |
| 1336486992 | William F Wolfe | Nurse Anesthetist, Certified Registered | 633d Medical Group, 77 Nealy Avenue, Joint Base Langley-eustis, VA 23665-2040 | 2013-01-15 |
| 1003101551 | Richard Zanetti Jr. | Pediatrics | 633d Medical Group, 77 Nealy Avenue, Joint Base Langley-eustis, VA 23665-2040 | 2011-06-13 |
| 1629398565 | Jeffrey Roger Herchler | Physician Assistant | 633d Medical Group, 77 Nealy Avenue, Joint Base Langley-eustis, VA 23665-2040 | 2010-06-02 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982228938 | Mai Stern | Student in an Organized Health Care Education/Training Program | Langley Afb Dental Clinic, Hampton, VA 23665 | 2020-06-05 |
| 1386273449 | Nicholas Thomas Nelson | Military Health Care Provider | 633d Medical Group, 76 Nealy Ave, Building #92, Apo, AA 23665 | 2020-04-02 |
| 1316574809 | Kimberly C Easterling | Student in an Organized Health Care Education/Training Program | 76 Nealy Avenue, Joint Base Langley-eustis, Hampton, VA 23665 | 2020-03-24 |
| 1851950026 | Erin Leigh Baldridge | Dentist | Joint Base Langley Eustis Dental Clinic, 76 Nealy Ave, Apo, AA 23665 | 2019-06-11 |
| 1669950739 | Anthony Interrante IIi | Nurse Practitioner | Usaf Hospital Langley, 77 Nealy Avenue, Hampton, VA 23665 | 2018-08-01 |
| 1588189310 | Stacey Marie Jackson | Psychologist | 11 Nealy Blvd, Hampton, VA 23665 | 2017-08-14 |
| 1285062216 | Michael John Vietti | Physician Assistant | 633 Mdg 77 Nealy Ave, Yorktown, VA 23665 | 2013-10-30 |
| 1396182234 | Micaela Jane Dagucon | General Practice | 633d Mdg/sghc, 77 Nealy Avenue, Joint Base Langley-eustis, VA 23665 | 2013-06-02 |
| 1912212051 | Michele Leigh Shirley | Pharmacist | 633d Medical Group Hospital, 77 Nealy Avenue, Building 257, Joint Base Langley-eustis, VA 23665 | 2010-08-13 |
| 1497915219 | Stephen Warren Porter | Dentist | 76 Nealy Ave, 1st Dental Squadron/sgd, Langley Air Force Base, VA 23665 | 2008-06-16 |
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| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740819911 | Charles W Hurt | Surgery | 195 Riverbend Dr Ste 1, Charlottesville, VA 22911-8708 | 2020-04-08 |
| 1720616261 | Katherine Maria Barrows | Surgery | 3300 Gallows Rd, Dept of Surgery, Falls Church, VA 22042-3307 | 2020-03-30 |
| 1891202412 | Valley Physician Enterprise, Inc. | Surgery | 1870 Amherst St Ste 2a, Winchester, VA 22601-2841 | 2018-01-04 |
| 1508388554 | Bon Secours-st. Mary's Hospital of Richmond, Inc. | Surgery | 5875 Bremo Rd Ste 110, Richmond, VA 23226-1934 | 2017-07-12 |
| 1457729048 | Donnarose Klemovitch | Surgery | 11226 Goldflower Ct, Fairfax Station, VA 22039-2026 | 2015-09-13 |
| 1114303922 | Loudoun Medical Group PC | Surgery | 19415 Deerfield Ave Ste 213, Lansdowne, VA 20176-8471 | 2015-08-04 |
| 1255728374 | Malinda Lyon | Surgery | 8150 Shore Drive, #522, Norfolk, VA 23518 | 2015-04-16 |
| 1760877377 | Caleb Luke Cutherell | Surgery | 2900 Lamb Cir Ste 302, Christiansburg, VA 24073-6341 | 2015-03-31 |
| 1457745143 | Dwayne North | Surgery | 7554 Hospital Dr Ste D303, Gloucester, VA 23061-4178 | 2015-03-20 |
| 1720479504 | Affinity Healthcare Group LLC | Surgery | 3356 Western Branch Blvd, #f, Chesapeake, VA 23321-5138 | 2015-02-14 |
| Find all providers with the same taxonomy | ||||
| City | JOINT BASE LANGLEY-EUSTIS |
| Zip Code | 23665 |
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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.