Active NPI
Tatum Raye Burdis, MA, LPC
- Professional Counselor
- Amarillo, TX
National Provider Identifier
1013527183
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 79395
- Practice address
- 7470 Golden Pond PL Ste 300
Amarillo, TX 79121-2100 - Phone
- (806) 356-9047
- Fax
- (806) 356-9046
- NPI assigned
- Aug 4, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 79395 | TX | Primary |
Addresses
Primary practice location
7470 Golden Pond PL Ste 300
Amarillo, TX 79121-2100
Mailing address
7470 Golden Pond PL Ste 300
Amarillo, TX 79121-2100
Phone (806) 356-9047
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | Amarillo | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective May 21, 2024 through May 21, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 79395 | TX | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jennings Counseling Services | Professional | Past | Accepting new patients |
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": "1596499200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1596499200000",
"number": "1013527183",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7470 GOLDEN POND PL STE 300",
"city": "AMARILLO",
"state": "TX",
"postal_code": "791212100",
"telephone_number": "806-356-9047",
"fax_number": "806-356-9046"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7470 GOLDEN POND PL STE 300",
"city": "AMARILLO",
"state": "TX",
"postal_code": "791212100",
"telephone_number": "806-356-9047",
"fax_number": "806-356-9046"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURDIS",
"first_name": "TATUM",
"middle_name": "RAYE",
"name_prefix": "Mrs.",
"credential": "MA, LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-08-04",
"last_updated": "2020-08-04",
"certification_date": "2020-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Counselor, Professional",
"state": "TX",
"license": "79395",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "Amarillo",
"affiliation": "N",
"endpointDescription": "private messaging",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "7470 Golden Pond Pl Ste 300",
"city": "Amarillo",
"state": "TX",
"country_code": "US",
"postal_code": "791212100",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Amarillo, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.