Jill Burbank, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1501002 Issued in KS

Practice address

802 W Broadway
Stafford, KS 67578

Phone

(620) 234-6826

Fax

(620) 234-5014

NPI assigned

Oct 11, 2006

Last updated

Jan 7, 2008By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in KS

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jill.burbank.p1@direct.edcomed.nextgenshare.com
• Direct secure messaging: jill.burbank@khindirect.org

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.

• Williams Medical Group Practice, LLC

  dba Integrity Urgent Care

  • Family Medicine Physician
  • Lawton, OK
  • NPI 1346608809

  KS

  Medicare reassignment NPD
• Western Plains Physician Practices,LLC

  dba Western Plains Orthopadeic Assocation

  • Orthopaedic Surgery Physician
  • Dodge City, KS
  • NPI 1942559554
  NPD
• Williams Medical Group Practice, LLC

  dba Integrity Urgent Care

  • Rural Health Clinic/Center
  • Collinsville, OK
  • NPI 1215751508
  NPD

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199664000000",
    "number": "1124117163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "802 W BROADWAY",
            "address_2": "PO BOX 309",
            "city": "STAFFORD",
            "state": "KS",
            "postal_code": "67578",
            "telephone_number": "620-234-6826",
            "fax_number": "620-234-5014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 W BROADWAY",
            "city": "STAFFORD",
            "state": "KS",
            "postal_code": "67578",
            "telephone_number": "620-234-6826",
            "fax_number": "620-234-5014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURBANK",
        "first_name": "JILL",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-11",
        "last_updated": "2008-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KS",
            "license": "1501002",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "426817",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200306410A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Orlena K Allen, OTA
• Larry D Ball, MD
• Thomas Anderson Bauer, M.D.
• Charles L Craig, PA
• Tamara L Farmer, ARNP
• Raquel Garza
• Grene Vision Group LLC
• Heart of Kansas Family Health Care, Inc. (Stafford Clinic Site)

• Physician Assistant in Stafford, KS
• Providers in Stafford, KS by specialty
• Physician Assistant in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2008; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.