Individual provider Active NPI

Dawn Renae Burnett, BSE - DYSLEXIA K-12

  • Developmental Therapist
  • Sherwood, AR
National Provider Identifier
1063061216
Registry record updated Sep 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental TherapistTaxonomy code 222Q00000X
Practice address
2001 E Kiehl Ave Ste 12
Sherwood, AR 72120-3123
Phone
(501) 864-8992
NPI assigned
Sep 10, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Therapist 222Q00000X AR Primary

Addresses

Primary practice location

2001 E Kiehl Ave Ste 12
Sherwood, AR 72120-3123

Mailing address

2001 E Kiehl Ave Ste 12
Sherwood, AR 72120-3123
Phone (501) 864-8992

Other identifiers 1

IdentifierTypeStateIssuer
252Y00000XMedicaidAR

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL bridgetohopeacademictherapy@gmail.com Direct

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

NPI Registry JSON

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

{
    "created_epoch": "1568073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568073600000",
    "number": "1063061216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 E KIEHL AVE STE 12",
            "city": "SHERWOOD",
            "state": "AR",
            "postal_code": "721203123",
            "telephone_number": "501-864-8992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 E KIEHL AVE STE 12",
            "city": "SHERWOOD",
            "state": "AR",
            "postal_code": "721203123",
            "telephone_number": "501-864-8992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURNETT",
        "first_name": "DAWN",
        "middle_name": "RENAE",
        "name_prefix": "Ms.",
        "credential": "BSE - DYSLEXIA K-12",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-10",
        "last_updated": "2019-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": "AR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "252Y00000X",
            "state": "AR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "bridgetohopeacademictherapy@gmail.com",
            "affiliation": "N",
            "endpointDescription": "Academic Intervention - Dyslexia Therapy",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2001 E Kiehl Ave Ste 12",
            "city": "Sherwood",
            "state": "AR",
            "country_code": "US",
            "postal_code": "721203123",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sherwood, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2019; 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.