Individual provider Active NPI

Nancy Anne Burchardt

  • Registered Nurse
  • Allegan, MI
National Provider Identifier
1083982458
Registry record updated May 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
4704086300 Issued in MI
Practice address
3285 122ND Ave
PO Drawer 130
Allegan, MI 49010-9511
Phone
(800) 795-6617
Fax
(269) 673-2738
NPI assigned
Dec 13, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 31, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 4704086300 MI Primary

Addresses

Primary practice location

3285 122ND Ave
PO Drawer 130
Allegan, MI 49010-9511

Mailing address

3285 122ND Ave
PO Drawer 130
Allegan, MI 49010-9511
Phone (800) 795-6617

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
4704086300MIMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1323734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464652800000",
    "number": "1083982458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3285 122ND AVE",
            "address_2": "PO DRAWER 130",
            "city": "ALLEGAN",
            "state": "MI",
            "postal_code": "490109511",
            "telephone_number": "800-795-6617",
            "fax_number": "269-673-2738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3285 122ND AVE",
            "address_2": "PO DRAWER 130",
            "city": "ALLEGAN",
            "state": "MI",
            "postal_code": "490109511",
            "telephone_number": "800-795-6617",
            "fax_number": "269-673-2738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURCHARDT",
        "first_name": "NANCY",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-12-13",
        "last_updated": "2016-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704086300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allegan, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 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.