Active NPI
Jessica Burson
- Nurse's Aide
- Decatur, GA
National Provider Identifier
1083037469
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse's Aide
- License
- CN0000051908
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| CN0000051908 | GA | MD | Nurse'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.