KEITH JAMES BOURGEOIS (NPI# 1720502628) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720502628 |
| Entity Type | Individual |
| Full Name | KEITH JAMES BOURGEOIS |
| Credential | FNP-C |
| Practice Address |
43 Baxter Blvd Portland ME 04101-1823 |
| Mailing Address |
P.o. Box 296 Freeport ME 04032 |
| Practice Telephone | 2077711717 |
| Mailing Telephone | 2074156399 |
| Enumeration Date | 2017-08-01 |
| Last Update Date | 2017-08-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
CNP171069 | ME | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457312183 | Keith Alan Bourgeois | Ophthalmology | 1315 St Joseph Pkwy, Suite 1601, Houston, TX 77002-8233 | 2006-03-31 |
| Street Address |
43 BAXTER BLVD |
| City | PORTLAND |
| State | ME |
| Zip Code | 04101-1823 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588648323 | William Maxwell | Otolaryngology | 43 Baxter Blvd, Portland, ME 04101-1823 | 2005-12-05 |
| 1619488004 | Carolyn Michelle Lebeis | Speech-Language Pathologist | 43 Baxter Blvd, Portland, ME 04101-1823 | 2017-10-12 |
| 1720533821 | Melissa Graziani | Audiologist | 43 Baxter Blvd, Portland, ME 04101-1823 | 2016-08-18 |
| 1982056347 | Megan Lynne Black | Nurse Practitioner | 43 Baxter Blvd, Portland, ME 04101-1823 | 2016-07-11 |
| 1942681168 | Katelyn Bennett | Physical Therapist | 43 Baxter Blvd, Portland, ME 04101-1823 | 2015-06-12 |
| 1679834030 | Karen Tartakoff | Audiologist | 43 Baxter Blvd, Portland, ME 04101-1823 | 2012-06-01 |
| 1700190519 | Gretchen F Preneta | Physician Assistant | 43 Baxter Blvd, Portland, ME 04101-1823 | 2010-08-04 |
| 1821325804 | Kevin M Burke | Otolaryngology | 43 Baxter Blvd, Portland, ME 04101-1823 | 2009-11-11 |
| 1275772691 | Michelle Allen Rioux | Physical Therapist | 43 Baxter Blvd, Portland, ME 04101-1823 | 2009-02-09 |
| 1922259324 | Donna Lynne Greenwood | Internal Medicine | 43 Baxter Blvd, Portland, ME 04101-1894 | 2008-10-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306450655 | Jocylin Egan | Nurse Practitioner | 442 Congress Street, 2nd Floor, Portland, ME 04101 | 2020-09-03 |
| 1255963559 | Portcity Home Healthcare LLC | In Home Supportive Care | 525 Forest Avenue, Suite 8, Portland, ME 04101 | 2020-02-05 |
| 1578101929 | Mohamed Hassan Mohamed | Student in an Organized Health Care Education/Training Program | 75 Lancaster St Ste 218a, Portland, ME 04101 | 2019-12-17 |
| 1841855301 | Portland Opioid Health Home | Counselor | 48 Free St., Mezzanine Level, Portland, ME 04101 | 2019-05-09 |
| 1093379224 | Alexandra Strawbridge Maurer | Acupuncturist | 50 A Cove Street, Portland, ME 04101 | 2019-04-23 |
| 1245719541 | Scott J Whited | Nurse Practitioner | 216 Vaughan St., Mcgeachy Hall, Portland, ME 04101 | 2018-08-08 |
| 1144733064 | Alixandria Elaine Marie Winchell | Massage Therapist | One City Center, Portland, ME 04101 | 2017-11-14 |
| 1417473638 | Rachel S Schwaner | Occupational Therapist | 78 Danforth Street, Apartment 6, Portland, ME 04101 | 2017-08-18 |
| 1023538154 | Derina Boothroyd | Audiologist-Hearing Aid Fitter | 985 Forest Ave., Portland, ME 04101 | 2017-06-20 |
| 1881123297 | Mark Mccullough | Social Worker | 57 Exchange Street, Suite 403, Portland, ME 04101 | 2017-06-08 |
| Find all providers in zip 04101 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043822794 | Danielle Langer | Nurse Practitioner | 35 Ridgeview Rd, Portland, CT 06480-4014 | 2020-08-23 |
| 1508476250 | Harrington Health Clinic | Nurse Practitioner | 310 Nw Glisan Street, Portland, OR 97209 | 2020-08-07 |
| 1114566650 | Sadie Garnache-poirier | Nurse Practitioner | 65 W Commercial St Ste 107, Portland, ME 04101-4789 | 2020-01-02 |
| 1902441629 | Jennifer Marie Colpitts | Nurse Practitioner | 1600 Congress St Ste B, Portland, ME 04102-2148 | 2019-11-18 |
| 1477102689 | Raquel A Bishop | Nurse Practitioner | 12400 Nw Cornell Rd Ste 100, Portland, OR 97229 | 2019-09-10 |
| 1265081640 | Christina Lee | Nurse Practitioner | 144 State St # 1, Portland, ME 04101-3776 | 2019-09-09 |
| 1407401474 | Abby Christine Vopal | Nurse Practitioner | 66 Bramhall St Fl 1, Portland, ME 04102-3355 | 2019-08-07 |
| 1770145294 | Cynthia Marie Martinez | Nurse Practitioner | 1145 Austin St, Portland, TX 78374-2013 | 2019-07-04 |
| 1528532306 | Matthew James Keelin | Nurse Practitioner | 6801 Ne Cornfoot Rd, Portland, OR 97218-2743 | 2019-01-15 |
| 1659847580 | Colleen Jeanette Scott | Nurse Practitioner | 650 Nw Irving St, Portland, OR 97209-1272 | 2018-10-18 |
| Find all providers in PORTLAND | ||||
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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.