Active NPI
Annika Burnett
- Psychiatry Physician
- Portland, OR
National Provider Identifier
1033640164
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- A158427
- Practice address
- 2705 E Burnside St
Portland, OR 97214 - Phone
- (424) 210-5858
- NPI assigned
- Mar 21, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Psychiatry Physician | 2084P0800X | A158427 | CA | Primary |
| Psychiatry Physician | 2084P0800X | 213705 | OR |
Addresses
Primary practice location
2705 E Burnside St
Portland, OR 97214
Mailing address
2705 E Burnside St Ste 206
Portland, OR 97214-1768
Other practice location 1
1730 Colby Ave
Los Angeles, CA 90025-4376
Phone (424) 210-5858
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | http://www.burnettpsychiatry.com |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Oct 25, 2021 through Oct 25, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 213705 | OR | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1490054400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1672963200000",
"number": "1033640164",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2705 E BURNSIDE ST STE 206",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972141768"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2705 E BURNSIDE ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "97214",
"telephone_number": "424-210-5858"
}
],
"practiceLocations": [
{
"address_1": "1730 Colby Ave",
"address_purpose": "LOCATION",
"city": "Los Angeles",
"state": "CA",
"postal_code": "900254376",
"country_code": "US",
"telephone_number": "424-210-5858",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BURNETT",
"first_name": "ANNIKA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-03-21",
"last_updated": "2023-01-06",
"certification_date": "2023-01-06",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "A158427",
"primary": true
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "OR",
"license": "213705",
"primary": false
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "http://www.burnettpsychiatry.com",
"affiliation": "N",
"address_1": "1730 Colby Ave",
"city": "Los Angeles",
"state": "CA",
"country_code": "US",
"postal_code": "900254376",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2023; 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.