DR. LARRY AVIS BOURG M.D.
NPI 1205800182
Specialist in Parker, CO

Q: What is Larry Bourg's NPI number?

The NPI number for Larry Bourg is 1205800182. It was assigned to this individual provider in the NPPES registry on February 15, 2006.

Q: What is Larry Bourg's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Q: When was this NPI record last updated?

The NPPES record for Larry Bourg was last updated on August 8, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since February 15, 2006PECOS Enrolled

12230 LIONESS WAY, PARKER, CO 80134(720) 644-9355 Get Directions Write a Review

NPPES record last updated: August 8, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Aug 8, 2023, Aug 29, 2022 (2 updates tracked since 2022).

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About Dr. Larry Avis Bourg M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. LARRY AVIS BOURG M.D. (NPI 1205800182) is an individual specialist in Parker, Colorado, licensed in Colorado (39560) and active in the NPI registry since February 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1205800182

Entity TypeIndividualMale

Primary Taxonomy174400000X

Provider Legal NameDR. LARRY AVIS BOURGCredential: M.D.

Location Address12230 LIONESS WAYParker, CO 80134-5603

Mailing Address9250 E Costilla Ave Ste 540Greenwood Village, CO 80112-3648 · (720) 644-9355

Phone(720) 644-9355

Sole ProprietorNo

Enumeration DateFebruary 15, 2006

Last NPPES UpdateAugust 8, 20232 updates tracked since enumeration

NPPES CertifiedAugust 8, 2023

✔ NPI 1205800182 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers

Taxonomy Code174400000X

License✔ Licensed in CO · 39560

Definition

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

12230 LIONESS WAY, Parker, CO 80134

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Other Identifiers 2

Medicaid93909365CO

Other013365CO · Kaiser Commercial Number

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Larry Avis Bourg M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Initial nursing facility care with high level of medical decision making, per day, if using time, 50 minutes or more 99306

An initial nursing facility visit is your first meeting with your healthcare team at a nursing facility. Lasting typically 45 minutes, this appointment involves a comprehensive health assessment and the creation of your personalized care plan. It's a crucial step to ensure your health and well-being.

72 services70 patients

Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309

A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.

32 services29 patients

Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes 99310

A follow-up nursing facility visit is a routine check-up that typically lasts about 35 minutes. During this visit, your health status is evaluated, any changes in your condition are noted, and necessary adjustments to your care plan are made. It's an essential part of maintaining your health.

15 services13 patients

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KIRSTEN DEROODE PA-C

Physician Assistant (Medical)