Jeremiah W Burkhart, PSY.D.

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

0810006349 Issued in VA

Practice address

180 Ferrum Mountain Rd
Ferrum, VA 24088-2939

Phone

(540) 365-4469

Fax

(540) 365-4272

NPI assigned

Jun 21, 2011

Last updated

Dec 13, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Family Care Center LLCGroup PAC ID 5991064420, 703 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/15315/brand/1/csg/1/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Family Care Center, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Franklin, TN
  • NPI 1124756085
  Medicare reassignment Care Compare group NPD
• Family Care Center, LLC

  • Psychiatry Physician
  • Mesa, AZ
  • NPI 1598535288

  Clinical

  NPD
• Mental Health Centers & Clinics of Tennessee

  dba Quinco Mental Health Center

  • Mental Health Counselor
  • Bolivar, TN
  • NPI 1255442794
  NPD (past)

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

{
    "created_epoch": "1308614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702425600000",
    "number": "1104112986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9",
            "city": "LAUREL FORK",
            "state": "VA",
            "postal_code": "243520009",
            "telephone_number": "276-398-1214",
            "fax_number": "276-398-1234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 FERRUM MOUNTAIN RD",
            "city": "FERRUM",
            "state": "VA",
            "postal_code": "240882939",
            "telephone_number": "540-365-4469",
            "fax_number": "540-365-4272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURKHART",
        "first_name": "JEREMIAH",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-21",
        "last_updated": "2023-12-13",
        "certification_date": "2023-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810006349",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "VA",
            "license": "0810006349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Notapplicable",
            "affiliation": "N",
            "address_1": "180 Ferrum Mountain Rd",
            "city": "Ferrum",
            "state": "VA",
            "country_code": "US",
            "postal_code": "240882939",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Hanako Baker, PSYD
• Kelsey Baugher, RD
• Emily Kaye Blalock, PMHNP-BC
• Joshua M Bradley
• Brittany K Butler, PA-C
• Kyle Calhoun, LPC
• Brittany M Cockram, PSYD
• Gabriel Lee Edmondson, D.O.
• Family Preservation Services, Inc

• Counseling Psychologist in Ferrum, VA
• Providers in Ferrum, VA by specialty
• Counseling Psychologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.