IndividualActive
Brian Bourbon, CERTIFIED PEDORTHIST
NPI 1790124923 · Specialist · Creve Coeur, MO
Brian Bourbon, CERTIFIED PEDORTHIST is a Specialist provider in Creve Coeur, MO (NPI 1790124923).
Provider details
- NPI number
- 1790124923
- Entity type
- Individual
- Primary specialty
- SpecialistOther Service Providers
- Credential
- CERTIFIED PEDORTHIST
- Sex
- Male
- Sole proprietor
- No
- License
- CPED3999 (MO)
Specialties & taxonomies
Other Service Providers
Profile Score
Detailed profile(78/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
13 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
11709 Old Ballas Rd
Suite 201
Creve Coeur, MO 63141-7029
Phone: (314) 432-1903
Fax: (314) 432-5105
Street-level locationGet directions
Mailing address
Po Box 419074
Creve Coeur, MO 63141-9074
Registry dates
- Enumerated
- 2013-06-20
- Last updated
- 2013-06-20
Frequently asked questions
- What is Brian Bourbon's NPI number?
- Brian Bourbon's National Provider Identifier (NPI) is 1790124923, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Brian Bourbon's specialty?
- Brian Bourbon is listed in the NPPES registry with a primary specialty of Specialist (Other Service Providers).
- Where is Brian Bourbon located?
- Brian Bourbon's practice location on file with NPPES is 11709 Old Ballas Rd, Creve Coeur, MO 63141-7029.
- What is Brian Bourbon's phone number?
- The practice phone number listed in the NPPES registry for Brian Bourbon is (314) 432-1903.
- Is Brian Bourbon's NPI active?
- Yes — Brian Bourbon's NPI (1790124923) is active in the NPPES registry as of the last update on 2013-06-20.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.