Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1144732579 Individual Practitioner Female Practitioner

Beth Alyson Bourquin , CNP

Nurse Practitioner - Pediatrics • Dayton, OH

Professional Overview & Biography Verified Profile Summary

Beth Bourquin, CNP is a registered healthcare professional specializing in Nurse Practitioner - Pediatrics in Dayton, OH. Practice services are available at 1 CHILDRENS PLZ under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

1 Childrens Plz

Dayton, OH 454041873

Telephone 9376415444
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Nurse Practitioner - Pediatrics in Dayton, OH

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 12.0 Yrs
State Avg: 12.0 Yrs
Regional Practice Density
58 Specialists

Practicing in Dayton, OH (1102 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2026-05-28
Nurse Practitioner - Pediatrics Primary Specialty

NUCC Taxonomy Code: 363LP0200X

State License OH APRN.CNP.021714

Definition to come...

Nurse Practitioner - Pediatrics, Critical Care

NUCC Taxonomy Code: 363LP0222X

State License OH 021714

Definition to come...

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
0250859 (OH)

Secondary Practice Locations

792 Northwoods Blvd

Vandalia, OH 453779462

Phone: 9376414236

3333 W Tech Rd

Miamisburg, OH 453420955

Phone: 9376415725

6044 Wilmington Pike

Centerville, OH 454597006

Phone: 9376413270

860 Valley St.

Dayton, OH 45404

Phone: 9376413060

662 N Main St

Springboro, OH 450669553

Phone: 9376415066

4475 Far Hills Ave

Kettering, OH 454292405

Phone: 9376413141

3301 Dayton Xenia Rd Ste 200

Beavercreek, OH 454322759

Phone: 9376415098

7787 Cox Ln

West Chester, OH 450696549

Phone: 5136448081

8501 Old Troy Pike

Huber Heights, OH 454241054

Phone: 9376414360

1711 Germantown Pike

Dayton, OH 45417

Phone: 9376413142

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Dr. Hemanth Lingadevaru , MD, MPH, FAAP

Pediatrics - Pediatric Critical Care Medicine

NPI 1003018425

Doctor of Medicine (M.D.), Master of Public Health, FAAP

Dr. Tanya Paul , MD

Pediatrics - Pediatric Emergency Medicine

NPI 1003369331

Doctor of Medicine (M.D.)

Nicole Scott

Physician Assistant

NPI 1003408238
Cody Mcmillan

Physician Assistant

NPI 1003538299
Tania Montenegro , MS, MPH

Genetic Counselor, MS

NPI 1003622473

Master of Science, Master of Public Health

Faith Callif-Daley , MS

Genetic Counselor, MS

NPI 1003985946

Master of Science

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
📍
Updated Business Mailing Address September 26, 2023

Registered at PO BOX 933432, CLEVELAND, OH 441930039 (Tel: 9376415871)

NPI Profile Active October 25, 2017

NPI status registered as active in NPPES database

📍
Updated Practice Location October 25, 2017

Registered at 1 CHILDRENS PLZ, DAYTON, OH 454041873 (Tel: 9376415444)

📍
Updated Business Mailing Address October 25, 2017

Registered at 1 CHILDRENS PLZ, DAYTON, OH 454041873 (Tel: 9376415871)

👤
Provider Name / Credentials Updated October 25, 2017

Recorded as BETH BOURQUIN, CNP

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) October 25, 2017

Nurse Practitioner (License #021714 in OH)

🟢
Initial NPI Registration & Enumeration October 25, 2017

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

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NPI Administrative Meta

NPI Number: 1144732579
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 25, 2017
Last Update: May 28, 2026
Sole Proprietor: Yes

Mailing Address

Po Box 933432

Cleveland, OH 441930039

Phone: 9376415072

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.