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DORETHA BOURNES NP
NPI 1487089546
Nurse Practitioner - Family in Monticello, MS

Active since September 09, 2013PECOS Enrolled
354 CUB BROWN RD, MONTICELLO, MS 39654(601) 587-4629 Get Directions Write a Review

NPPES record last updated: September 9, 2013. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Doretha Bournes Np NPPES

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

DORETHA BOURNES NP (NPI 1487089546) is an individual family provider in Monticello, Mississippi, licensed in Mississippi (R858932) and active in the NPI registry since September 2013. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1487089546
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameDORETHA BOURNESCredential: NP
Location Address354 CUB BROWN RDMonticello, MS 39654-7505
Mailing Address354 Cub Brown RdMonticello, MS 39654-7505 · (601) 587-4629
Phone(601) 587-4629
Sole ProprietorYes
Enumeration DateSeptember 9, 2013
✔ NPI 1487089546 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in MS · R858932
354 CUB BROWN RD, Monticello, MS 39654
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Doretha Bournes Np 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.

Medicare Billing Reassignment

Medicare enrollment records show Doretha Bournes reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Community Care Health Network LLC
368 mi
Nurse Practitioner
424 CHURCH ST STE 220
Nashville, TN 37219
  • Reassigned Medicare billing, Mississippi enrollment
  • 195 clinicians in this Medicare group
NPI 1619368842 (877) 564-3627

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 39654 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$80.50 typical visit price
range $51.65 – $159.18
Typical copayment $20.12 (range $12.91 – $39.79)
Most-billed visit code 99203
Established Patient
$92.20 typical visit price
range $16.15 – $129.61
Typical copayment $23.05 (range $4.03 – $32.40)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Doretha Bournes's NPI number?

The NPI number for Doretha Bournes is 1487089546. It was assigned to this individual provider in the NPPES registry on September 9, 2013.

Where is Doretha Bournes located?

Doretha Bournes practices at 354 Cub Brown Rd, Monticello, MS 39654. The listed phone number is (601) 587-4629.

What is Doretha Bournes's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Doretha Bournes enrolled in Medicare?

Yes. Doretha Bournes is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Doretha Bournes's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Doretha Bournes reassigns Medicare benefits to Community Care Health Network LLC (Nashville, TN). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Doretha Bournes's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Doretha Bournes was last updated on September 9, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.