Active NPI
Robert J Burk Jr., CRNA
- Certified Registered Nurse Anesthetist
- Fort Worth, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- AP125348
- Practice address
- 801 7TH Ave
Fort Worth, TX 76104-2733 - Phone
- (682) 885-4054
- NPI assigned
- Dec 9, 2005
- Last updated
- Feb 23, 2022
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | RN507103L | PA | |
| Certified Registered Nurse Anesthetist | 367500000X | AP61122412 | WA | |
| Certified Registered Nurse Anesthetist | 367500000X | AP125348 | TX | Primary |
Addresses
Primary practice location
801 7TH Ave
Fort Worth, TX 76104-2733
Mailing address
PO Box 733784
Dallas, TX 75373-3784
Phone (682) 885-6483
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | rburk12691@CookChildrens.direct-ci.com | ||
| SOAP URL | https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX, WA
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AP61122412 | WA | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cook Children's Physician Network | Current | Accepting new patients | |
| Kaiser Foundation Health Plan of Washington | Current | Accepting new patients | |
| Kaiser Foundation Health Plan of Washington | Current | Accepting new patients | |
| Kaiser Foundation Health Plan of Washington | Current | Accepting new patients | |
| Cook Children's Physician Network | Current | Accepting new patients | |
| Uniontown Anesthesia Associates, LTD | Past | Accepting new patients | |
| Western Pennsylvania Anesthesia Associates, LTD. | Past | Accepting new patients | |
| Wheeling Hospital, Inc. | Nurse Anesthetist, Certified Registered | Past | Accepting new patients |
Locations
801 7th Ave
Ft Worth, TX 76104
Phone (682) 885-4054
136 El Chico Trl
Ste 102
Willow Park, TX 76087
Phone (817) 441-5412
200 15th Ave E
Seattle, WA 98112
Phone (206) 326-4530
209 Martin Luther King Jr Way
Tacoma, WA 98405
Phone (253) 596-3300
9505 S Steele St
Tacoma, WA 98444
Phone (253) 597-6800
Interoperability endpoints
- rburk12691@cookchildrens.direct-ci.com
Organizations & group practices 8
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.
-
- Pediatrics Physician
- Fort Worth, TX
- NPI 1750369203
-
- Multi-Specialty Clinic/Center
- Seattle, WA
- NPI 1396810701
-
- Pediatrics Physician
- Fort Worth, TX
- NPI 1083472062
-
- Multi-Specialty Clinic/Center
- Renton, WA
- NPI 1124264577
-
dba Everett Medical Center
- Multi-Specialty Clinic/Center
- Everett, WA
- NPI 1386935351
-
- Anesthesiology Physician
- Uniontown, PA
- NPI 1023093192
-
- Pain Medicine (Anesthesiology) Physician
- Pittsburgh, PA
- NPI 1386639847
-
- Anesthesiology Physician
- Wheeling, WV
- NPI 1922282581
Nurse Anesthetist, Certified Registered
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1134086400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1645574400000",
"number": "1114902459",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 733784",
"city": "DALLAS",
"state": "TX",
"postal_code": "753733784",
"telephone_number": "682-885-6483",
"fax_number": "682-885-3113"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "801 7TH AVE",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761042733",
"telephone_number": "682-885-4054"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURK",
"first_name": "ROBERT",
"middle_name": "J",
"name_suffix": "Jr.",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-09",
"last_updated": "2022-02-23",
"certification_date": "2022-02-23",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "PA",
"license": "RN507103L",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "WA",
"license": "AP61122412",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "TX",
"license": "AP125348",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "rburk12691@CookChildrens.direct-ci.com",
"affiliation": "N",
"address_1": "801 7th Ave",
"city": "Fort Worth",
"state": "TX",
"country_code": "US",
"postal_code": "761042733",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync",
"affiliation": "N",
"endpointDescription": "Carequality",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "209 Martin Luther King Jr Way",
"city": "Tacoma",
"state": "WA",
"country_code": "US",
"postal_code": "984054265",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.