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Deactivated NPI 1174513303 Deactivated / Inactive NPI Male Practitioner

Dr. Robert I Bourne , MD

General Practice • Camden, TN

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Robert Bourne has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date October 27, 2005
NPI Deactivation Date May 24, 2021
Total Practice Duration ~16 Years of Practice (2005 – 2021)

Professional Overview & Biography Verified Profile Summary

Dr. Robert Bourne, MD was a registered General Practice practicing in Camden, TN. Throughout an active medical career spanning 16 years, Dr. Bourne provided care at the practice location at 101 HOSPITAL DR until profile deactivation on 2021-05-24.

Practice Location & Contact Primary Location

Practice Address

101 Hospital Dr

Camden, TN 383201617

Telephone 7315842020
Associated Practice Facility / Clinic
🏢 Agape Family Wellness Clinic Facility NPI 1831511146

Specialty Benchmarks & Practice Insights

Comparative analytics for General Practice in Camden, TN

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 34.2 Yrs
Regional Practice Density
2 Specialists

Practicing in Camden, TN (202 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

General Practice Primary Specialty

NUCC Taxonomy Code: 208D00000X

State License TN MD2641

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.

Practice Associates & Co-Workers

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

1 Associated Practitioners
Verneda Herring , APN

Nurse Practitioner - Family

NPI 1992008700

Advanced Practice Nurse

Career & Practice History Timeline

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

7 Historical Events
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NPI Profile Deactivated May 24, 2021

Record deactivated on May 24, 2021

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 101 HOSPITAL DR, CAMDEN, TN 383201617 (Tel: 7315842020)

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Updated Business Mailing Address July 08, 2007

Registered at 101 HOSPITAL DR, CAMDEN, TN 383201617 (Tel: 7315842020)

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Provider Name / Credentials Updated July 08, 2007

Recorded as ROBERT BOURNE, MD

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

General Practice (License #MD2641 in TN)

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Initial NPI Registration & Enumeration October 27, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1174513303
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 27, 2005
Last Update: July 08, 2007
Deactivation Date: May 24, 2021

Mailing Address

101 Hospital Dr

Camden, TN 383201617

Phone: 7315842020

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.