Individual provider Active NPI

Yvonne M Burgess, APN

  • Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist
  • Vineland, NJ
National Provider Identifier
1013229822
Registry record updated Nov 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0807X
License
26NC04275400 Issued in NJ
Practice address
629 E Wood St
Ste 108
Vineland, NJ 08360-3752
Phone
(856) 692-5600
Fax
(856) 692-5601
NPI assigned
Jul 9, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist 364SP0807X 26NC04275400 NJ Primary
Adult Psychiatric/Mental Health Clinical Nurse Specialist 364SP0809X 26NC04275400 NJ
Registered Nurse 163W00000X RN350687L PA

Addresses

Primary practice location

629 E Wood St
Ste 108
Vineland, NJ 08360-3752

Mailing address

629 E Wood St
Ste 108
Vineland, NJ 08360-3752
Phone (856) 692-5600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20160711000251 NJ Practitioner - Certified Clinical Nurse Specialist (CNS) 3870882160 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Clinical Nurse Specialist (CNS)
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

629 E Wood St
Suite 108
Vineland, NJ 08360-3752
Phone (856) 692-5600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Certified Nurse Specialist

State licenses

LicenseStateTypeSpecialty
RN350687LPAMDRegistered Nurse

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1278633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478563200000",
    "number": "1013229822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "629 E WOOD ST",
            "address_2": "STE 108",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083603752",
            "telephone_number": "856-692-5600",
            "fax_number": "856-692-5601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "629 E WOOD ST",
            "address_2": "STE 108",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083603752",
            "telephone_number": "856-692-5600",
            "fax_number": "856-692-5601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURGESS",
        "first_name": "YVONNE",
        "middle_name": "M",
        "credential": "APN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-09",
        "last_updated": "2016-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0807X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Child & Adolescent",
            "state": "NJ",
            "license": "26NC04275400",
            "primary": true
        },
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "NJ",
            "license": "26NC04275400",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN350687L",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vineland, NJ

Sources for this page

Verify at the official NPI Registry.