Individual provider Active NPI

Elizabeth Kay Burkern

  • Registered Nurse
  • Portland, OR
National Provider Identifier
1093006264
Registry record updated Apr 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
200941767RN Issued in OR
Practice address
6027 SW Kelly Ave
Portland, OR 97239-3732
Phone
(503) 260-5852
NPI assigned
Apr 22, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 200941767RN OR Primary
Registered Nurse 163W00000X RN60117895 WA

Addresses

Primary practice location

6027 SW Kelly Ave
Portland, OR 97239-3732

Mailing address

6027 SW Kelly Ave
Portland, OR 97239-3732
Phone (503) 260-5852

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
200941767RNORMDRegistered Nurse
RN60117895WAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1303430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303430400000",
    "number": "1093006264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6027 SW KELLY AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393732",
            "telephone_number": "503-260-5852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6027 SW KELLY AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393732",
            "telephone_number": "503-260-5852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURKERN",
        "first_name": "ELIZABETH",
        "middle_name": "KAY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-22",
        "last_updated": "2011-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "200941767RN",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN60117895",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2011; 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.