Active NPI
Lucas William Burkhardt, FNP-BC
- Nurse Practitioner
- Shadyside, OH
National Provider Identifier
1144734781
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- APRN.CNP.022040
- Practice address
- 3948 Central Ave
Shadyside, OH 43947-1310 - Phone
- (740) 325-1313
- NPI assigned
- Nov 17, 2017
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | APRN.CNP.022040 | OH | Primary |
Addresses
Primary practice location
3948 Central Ave
Shadyside, OH 43947-1310
Mailing address
569 W 43Rd St
Shadyside, OH 43947-1026
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180130002747 | OH | Practitioner - Nurse Practitioner | 1052671682 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1510876800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1510876800000",
"number": "1144734781",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "569 W 43RD ST",
"city": "SHADYSIDE",
"state": "OH",
"postal_code": "439471026"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3948 CENTRAL AVE",
"city": "SHADYSIDE",
"state": "OH",
"postal_code": "439471310",
"telephone_number": "740-325-1313"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURKHARDT",
"first_name": "LUCAS",
"middle_name": "WILLIAM",
"credential": "FNP-BC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-11-17",
"last_updated": "2017-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "OH",
"license": "APRN.CNP.022040",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shadyside, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2017; 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.