Individual provider Active NPI

Jennifer Burgess, NP

  • Family Nurse Practitioner
  • San Diego, CA
National Provider Identifier
1174063226
Registry record updated Nov 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95005397 Issued in CA
Practice address
10790 Rancho Bernardo Rd
Mail Drop 4S-205 Desk 2368
San Diego, CA 92127-5527
Phone
(858) 927-5527
NPI assigned
Mar 7, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 7, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95005397 CA Primary

Addresses

Primary practice location

10790 Rancho Bernardo Rd
Mail Drop 4S-205 Desk 2368
San Diego, CA 92127-5527

Mailing address

13334 Rollin Glen Rd
Poway, CA 92064-5131
Phone (858) 231-4523

Other practice location 1

13334 Rollin Glen Rd
Poway, CA 92064-5131
Phone (858) 231-4523

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20191213000927 CA Practitioner - Nurse Practitioner 7113350638 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Scripps HealthGroup PAC ID 9234033853, 1,450 clinicians

Practice addresses (Care Compare)

2176 Salk Ave
Carlsbad, CA 92008-7346
Phone (760) 827-7200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95005397CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Scripps Health Current Accepting new patients
Scripps Health Current Accepting new patients
Scripps Health CurrentSince Nov 1, 2019 Accepting new patients
Scripps Health Current Accepting new patients
Scripps Health CurrentSince Nov 1, 2019 Accepting new patients

Locations

2176 Salk Ave
Carlsbad, CA 92008
Phone (760) 827-7200

9888 Genesee Ave
La Jolla, CA 92037
Phone (858) 457-4123

File 54433
Los Angeles, CA 90074
Phone (858) 784-5645

10790 Rancho Bernardo Rd
#4S205
San Diego, CA 92127
Phone (858) 605-7171

10790 Rancho Bernardo Rd
San Diego, CA 92127
Phone (858) 554-2626

Interoperability endpoints

  • Direct secure messaging: jburgess323167@scrippshlth.medalliesdirect.net

Organizations & group practices 5

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": "1488844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573084800000",
    "number": "1174063226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13334 ROLLIN GLEN RD",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "920645131",
            "telephone_number": "858-231-4523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10790 RANCHO BERNARDO RD",
            "address_2": "MAIL DROP 4S-205 DESK 2368",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921275527",
            "telephone_number": "858-927-5527"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13334 Rollin Glen Rd",
            "address_purpose": "LOCATION",
            "city": "Poway",
            "state": "CA",
            "postal_code": "920645131",
            "country_code": "US",
            "telephone_number": "858-231-4523",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURGESS",
        "first_name": "JENNIFER",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-07",
        "last_updated": "2019-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95005397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.