Chanell Raven Bourne, MD
NPI 1356089775ActiveIndividual· Student in an Organized Health Care Education/Training Program· Providence, RI
Student in an Organized Health Care Education/Training Program (MD) in Providence, Rhode Island, licensed in RI, with an NPI issued in May 2022. Part D covered 58 prescriptions written in 2024, 97% of them generic.
Overview
| NPI | 1356089775 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | MD |
| Sole proprietor | No |
| NPI issued | May 25, 2022 |
| Last updated in NPPES | May 25, 2022 |
| Certified by provider | May 25, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Student in an Organized Health Care Education/Training Program Primary | 390200000X | LP05536 | RI |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
Part D prescriptions in 2024
| Prescriptions (claims) | 58 · 62 30-day fills |
|---|---|
| Patients | 47 |
| Total drug cost | $426.48 |
| Generic share | 97% of claims |
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