Individual provider Active NPI

Brittany Elizabeth Burchfield, PHD

  • Clinical Psychologist
  • Decatur, GA
National Provider Identifier
1134218050
Registry record updated Dec 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY002898 Issued in GA
Practice address
2711 Irvin Way Ste 211
Decatur, GA 30030-1724
Phone
(404) 501-0001
Fax
(404) 501-0023
NPI assigned
Oct 11, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 26, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY002898 GA Primary

Addresses

Primary practice location

2711 Irvin Way Ste 211
Decatur, GA 30030-1724

Mailing address

2711 Irvin Way Ste 211
Decatur, GA 30030-1724
Phone (404) 501-0001

Other identifiers 2

IdentifierTypeStateIssuer
329469212CMedicaidGA
202I689748OtherGAMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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

Enrollment IDStateProvider typePAC IDDetails
I20090422000463 GA Practitioner - Clinical Psychologist 9931256310 Practice locations: Decatur, GA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

809 Church St
Decatur, GA 30030-1870
Phone (404) 585-8617

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY002898GAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388016000000",
    "number": "1134218050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2711 IRVIN WAY STE 211",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300301724",
            "telephone_number": "404-501-0001",
            "fax_number": "404-501-0023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2711 IRVIN WAY STE 211",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300301724",
            "telephone_number": "404-501-0001",
            "fax_number": "404-501-0023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURCHFIELD",
        "first_name": "BRITTANY",
        "middle_name": "ELIZABETH",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-11",
        "last_updated": "2013-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "PSY002898",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "329469212C",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "202I689748",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

Verify at the official NPI Registry.