Active NPI
Steven Eugene Burback, ATC, LAT
- Athletic Trainer
- Hobbs, NM
National Provider Identifier
1104859057
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 333
- Practice address
- 6610 N Lovington Hwy
Hobbs, NM 88240-9120 - Phone
- (505) 392-6561
- NPI assigned
- Jul 7, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 333 | NM | Primary |
Addresses
Primary practice location
6610 N Lovington Hwy
Hobbs, NM 88240-9120
Mailing address
10711 Rosalie Dr
Northglenn, CO 80233-3551
Phone (505) 392-0212
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 333 | Other | NM | NEW MEXICO LICENSE NUMBER |
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 |
|---|---|---|---|
| 333 | NM | MD | Occupational Vision Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152230400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1104859057",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10711 ROSALIE DR",
"city": "NORTHGLENN",
"state": "CO",
"postal_code": "802333551",
"telephone_number": "505-392-0212"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6610 N LOVINGTON HWY",
"city": "HOBBS",
"state": "NM",
"postal_code": "882409120",
"telephone_number": "505-392-6561"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURBACK",
"first_name": "STEVEN",
"middle_name": "EUGENE",
"name_prefix": "Mr.",
"credential": "ATC, LAT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "NM",
"license": "333",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NEW MEXICO LICENSE NUMBER",
"identifier": "333",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hobbs, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.