Individual provider Active NPI

William A. Burkhart, PH.D.

  • Clinical Psychologist
  • Shoreline, WA
National Provider Identifier
1043234933
Registry record updated May 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY1203 Issued in WA
Practice address
20056 19TH Ave NE
Shoreline, WA 98155-1211
Phone
(206) 365-1435
Fax
(206) 365-1428
NPI assigned
Jul 26, 2006
Last updated
May 15, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 15, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY1203 WA Primary

Addresses

Primary practice location

20056 19TH Ave NE
Shoreline, WA 98155-1211

Mailing address

20056 19TH Ave NE
Shoreline, WA 98155-1211
Phone (206) 365-1435

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060914000607 WA Practitioner - Clinical Psychologist 9537163019 Practice locations: Shoreline, WA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

20056 19TH Ave NE
Shoreline, WA 98155-1211

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PY1203WAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210809600000",
    "number": "1043234933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20056 19TH AVE NE",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981551211",
            "telephone_number": "206-365-1435",
            "fax_number": "206-365-1428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20056 19TH AVE NE",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981551211",
            "telephone_number": "206-365-1435",
            "fax_number": "206-365-1428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURKHART",
        "first_name": "WILLIAM",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2008-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY1203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shoreline, WA

Sources for this page

Verify at the official NPI Registry.