Individual provider Active NPI

Anna Elizabeth Glass Burgess, MD

  • Family Medicine Physician
  • Jackson, TN
National Provider Identifier
1043483050
Registry record updated Nov 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD45990 Issued in TN
Practice address
2863 Highway 45 Byp
Jackson, TN 38305-3618
Phone
(731) 664-1375
Fax
(731) 664-1378
NPI assigned
Apr 10, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD45990 TN Primary

Addresses

Primary practice location

2863 Highway 45 Byp
Jackson, TN 38305-3618

Mailing address

PO Box 400
Jackson, TN 38302-0400
Phone (731) 423-8697

Other identifiers 1

IdentifierTypeStateIssuer
1520365MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101006000773 TN Practitioner - Family PracticePractitioner - Emergency Medicine 0941492144 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Emergency Medicine
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Jackson Clinic PAGroup PAC ID 2668376872, 171 clinicians

Practice addresses (Care Compare)

101 Garrett Dr
Medina, TN 38355-9641
Phone (731) 422-0355

145 Innovation Dr
Jackson, TN 38305-3019
Phone (731) 422-0213

1893 S Highland Ave
Jackson, TN 38301-7799
Phone (731) 423-5585

22 2ND Ave
Huntingdon, TN 38344-3806
Phone (731) 422-0213

2859 Hwy 45 Byp
Jackson, TN 38305-3618
Phone (731) 664-1375

2863 Hwy 45 Byp
Jackson, TN 38305-3618
Phone (731) 664-1375

3568 Chere Carol Rd
Humboldt, TN 38343-3639
Phone (731) 664-1375

619 Skyline Dr
Jackson, TN 38301-3903
Phone (731) 422-0213

622 W Market St
Bolivar, TN 38008-2241
Phone (731) 658-2885

Hospital & facility affiliations

  • Volunteer Home Care Home health agency, Humboldt, TN, CCN 447557
  • Amedisys Home Health Care Home health agency, Jackson, TN, CCN 447278
  • Jackson-Madison County General Hospital Hospital, Jackson, TN, CCN 440002

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD45990TNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jackson Clinic PA Family Medicine CurrentSince Jul 1, 2011 Accepting new patients
Jackson Clinic PA CurrentSince Jul 1, 2011 Accepting new patients

Locations

87 Murray Guard Dr
Ste B
Jackson, TN 38305
Phone (731) 664-1375

2863 Highway 45 Byp
Jackson, TN 38305
Phone (731) 660-8300

Interoperability endpoints

  • Direct secure messaging: annaburgess@jcpa.allscriptsdirect.net

Organizations & group practices 2

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1207785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354147200000",
    "number": "1043483050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 400",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383020400",
            "telephone_number": "731-423-8697",
            "fax_number": "731-422-5743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2863 HIGHWAY 45 BYP",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383053618",
            "telephone_number": "731-664-1375",
            "fax_number": "731-664-1378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURGESS",
        "first_name": "ANNA",
        "middle_name": "ELIZABETH GLASS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-10",
        "last_updated": "2012-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "MD45990",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1520365",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

Verify at the official NPI Registry.