Individual provider Active NPI

Jessica Burson

  • Nurse's Aide
  • Decatur, GA
National Provider Identifier
1083037469
Registry record updated Jan 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse's AideTaxonomy code 376K00000X
License
CN0000051908 Issued in GA
Practice address
3011 Rainbow Dr Ste 109B
Decatur, GA 30034-1643
Phone
(770) 771-2014
NPI assigned
Jan 21, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 28, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse's Aide 376K00000X CN0000051908 GA Primary

Addresses

Primary practice location

3011 Rainbow Dr Ste 109B
Decatur, GA 30034-1643

Mailing address

8170 Autumn Green Dr
Fairburn, GA 30213-4214
Phone (770) 771-2014

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
CN0000051908GAMDNurse's Aide

NPI Registry JSON

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

{
    "created_epoch": "1390262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453939200000",
    "number": "1083037469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 AUTUMN GREEN DR",
            "city": "FAIRBURN",
            "state": "GA",
            "postal_code": "302134214",
            "telephone_number": "770-771-2014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3011 RAINBOW DR STE 109B",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300341643",
            "telephone_number": "770-771-2014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURSON",
        "first_name": "JESSICA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-01-21",
        "last_updated": "2016-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "GA",
            "license": "CN0000051908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2016; 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.