Charles Ernest Burt, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

0810001508 Issued in VA

Practice address

1800 Michael Faraday Dr Ste 206
Reston, VA 20190-5312

Phone

(703) 899-3290

Fax

(703) 723-9404

NPI assigned

Jan 17, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in DC

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

Specialty

Clinical Psychologist

Education

Other, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Charles E. Burt, PH.D. and Associates, P.C.

  • Clinical Psychologist
  • Reston, VA
  • NPI 1518007640

  DC

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582934400000",
    "number": "1043362197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22563 FOREST MANOR DR",
            "city": "ASHBURN",
            "state": "VA",
            "postal_code": "201486900",
            "telephone_number": "703-899-3290",
            "fax_number": "703-723-9404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 MICHAEL FARADAY DR STE 206",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201905312",
            "telephone_number": "703-899-3290",
            "fax_number": "703-723-9404"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21351 Gentry Dr Ste 250",
            "address_purpose": "LOCATION",
            "city": "Sterling",
            "state": "VA",
            "postal_code": "201668514",
            "country_code": "US",
            "telephone_number": "703-899-3290",
            "fax_number": "703-723-9404",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "22563 Forest Manor Dr",
            "address_purpose": "LOCATION",
            "city": "Ashburn",
            "state": "VA",
            "postal_code": "201486900",
            "country_code": "US",
            "telephone_number": "703-899-3290",
            "fax_number": "703-723-9404",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURT",
        "first_name": "CHARLES",
        "middle_name": "ERNEST",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-17",
        "last_updated": "2020-02-29",
        "certification_date": "2020-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810001508",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS PROVIDER ID",
            "identifier": "031200",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BXBS RESTON ADDR",
            "identifier": "107617",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL EMPLOYER ID #",
            "identifier": "54-1848078",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tamra Marie Bullard, PT
• Paul Burke, M.D.
• Colleen Burkhart, PA-C
• Gregory Burkhart, M.D.
• Amanda Dora Burnette, PA-C
• Arlene Butler, M.S.W.
• Cara Elizabeth Butler
• Scott Michael Butler, MD
• Katherine Butters
• Leah Byars, DDS

• Clinical Psychologist in Reston, VA
• Providers in Reston, VA by specialty
• Clinical Psychologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.