Individual provider Active NPI

Judy A Burk, MD

  • Psychiatry Physician
  • Bangor, ME
National Provider Identifier
1003905647
Registry record updated Jan 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
011488 Issued in ME
Practice address
656 State St
Dorothea Dix Psychiatric Center
Bangor, ME 04401-5609
Phone
(207) 941-4263
Fax
(207) 941-4151
NPI assigned
Oct 12, 2006
Last updated
Jan 11, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 011488 ME Primary

Addresses

Primary practice location

656 State St
Dorothea Dix Psychiatric Center
Bangor, ME 04401-5609

Mailing address

656 State St
Dorothea Dix Psychiatric Center
Bangor, ME 04401-5609
Phone (207) 941-4263

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
011488MEMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389398400000",
    "number": "1003905647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "656 STATE ST",
            "address_2": "DOROTHEA DIX PSYCHIATRIC CENTER",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044015609",
            "telephone_number": "207-941-4263",
            "fax_number": "207-941-4151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "656 STATE ST",
            "address_2": "DOROTHEA DIX PSYCHIATRIC CENTER",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044015609",
            "telephone_number": "207-941-4263",
            "fax_number": "207-941-4151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURK",
        "first_name": "JUDY",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2014-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "ME",
            "license": "011488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bangor, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.