Individual provider Active NPI

Anna Philbeck Burgess, FNP

  • Family Nurse Practitioner
  • Charlotte, NC
National Provider Identifier
1003265943
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5008613 Issued in NC
Practice address
4135 Southstream Blvd
Charlotte, NC 28217-4523
Phone
(704) 631-1200
NPI assigned
Jun 10, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5008613 NC
Family Nurse Practitioner 363LF0000X 5008613 NC Primary

Addresses

Primary practice location

4135 Southstream Blvd
Charlotte, NC 28217-4523

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address aburgess915113@CarolinasHealthcareSystem.direct-ci.com Atrium Health
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other ABILITY Network

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161018002801 NC Practitioner - Nurse Practitioner 1759679152 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5008613NCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
DLP Rutherford Physician Practices LLC Family CurrentSince Jul 26, 2016 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince Jul 25, 2022 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince Jul 25, 2022 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority Current Accepting new patients
DLP Rutherford Physician Practices LLC CurrentSince Jul 26, 2016 Accepting new patients
DLP Rutherford Physician Practices LLC Past Accepting new patients

Locations

100 N 6th St
Ste 900A
Minneapolis, MN 55403

4135 Southstream Blvd
Charlotte, NC 28217
Phone (704) 631-1200

200 Medical Park Dr
Ste 250
Concord, NC 28025
Phone (704) 403-2740

212 Allendale Dr
Forest City, NC 28043
Phone (828) 245-3575

605 NC 120 Hwy
Mooresboro, NC 28114
Phone (828) 453-0703

288 S Ridgecrest Ave
Rutherfordton, NC 28139
Phone (252) 808-6000

Interoperability endpoints

  • Direct secure messaging: aburgess915113@carolinashealthcaresystem.direct-ci.com
  • FHIR API: https://api.platform.athenahealth.com/9573/brand/2/csg/1/fhir/r4

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1465516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1003265943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19305",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282199305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4135 SOUTHSTREAM BLVD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282174523",
            "telephone_number": "704-631-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURGESS",
        "first_name": "ANNA",
        "middle_name": "PHILBECK",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-10",
        "last_updated": "2024-07-15",
        "certification_date": "2020-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5008613",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5008613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aburgess915113@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "4135 Southstream Blvd",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282174523",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "ABILITY Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.