Individual provider Active NPI

Sean M Burket, CRNP

  • Acute Care Nurse Practitioner
  • Paoli, PA
National Provider Identifier
1154510568
Registry record updated Sep 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
SP009817 Issued in PA
Practice address
255 West Lancaster Avenue
BLDG 2 - Suite 328
Paoli, PA 19301-1766
Phone
(610) 647-2400
Fax
(610) 647-3902
NPI assigned
Oct 22, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X SP009817 PA Primary

Addresses

Primary practice location

255 West Lancaster Avenue
BLDG 2 - Suite 328
Paoli, PA 19301-1766

Mailing address

207 N Broad St
3Rd Floor
Philadelphia, PA 19107-1500
Phone (267) 479-4142

Other identifiers 1

IdentifierTypeStateIssuer
1031628290001MedicaidPA

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)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Cardiology, Inc. Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1193011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569196800000",
    "number": "1154510568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 N BROAD ST",
            "address_2": "3RD FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191071500",
            "telephone_number": "267-479-4142",
            "fax_number": "215-463-3820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 WEST LANCASTER AVENUE",
            "address_2": "BLDG 2 - SUITE 328",
            "city": "PAOLI",
            "state": "PA",
            "postal_code": "193011766",
            "telephone_number": "610-647-2400",
            "fax_number": "610-647-3902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURKET",
        "first_name": "SEAN",
        "middle_name": "M",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-22",
        "last_updated": "2019-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "PA",
            "license": "SP009817",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1031628290001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Paoli, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.