Individual provider Active NPI

Katherine Burkett, DDS

  • Dentist
  • Columbus, IN
National Provider Identifier
1033788153
Registry record updated Jun 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
12013642A Issued in IN
Practice address
530 Plaza Dr Ste J
Columbus, IN 47201-2940
Phone
(812) 376-9335
NPI assigned
Jun 22, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 12013642A IN Primary

Addresses

Primary practice location

530 Plaza Dr Ste J
Columbus, IN 47201-2940

Mailing address

4526 Woodland Dr
Indianapolis, IN 46254-2093

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
12013642AINMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Adam D. Clock, D.D.S., L.L.C. PastSince Jun 27, 2021 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": "1624320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624320000000",
    "number": "1033788153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4526 WOODLAND DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462542093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 PLAZA DR STE J",
            "city": "COLUMBUS",
            "state": "IN",
            "postal_code": "472012940",
            "telephone_number": "812-376-9335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURKETT",
        "first_name": "KATHERINE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-22",
        "last_updated": "2021-06-22",
        "certification_date": "2021-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12013642A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2021; 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.