Bobbie Jo Burdette

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN44075NP Issued in WV

Practice address

202 Corbin Heights Cir
Given, WV 25245-8072

Phone

(304) 532-4463

NPI assigned

Feb 5, 2019

Last updated

Feb 5, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WV

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

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Charleston Treatment Center, LLC

  • Methadone Clinic
  • Charleston, WV
  • NPI 1720480668
  Medicare reassignment NPD
• Charleston Treatment Center, LLC.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Charleston, WV
  • NPI 1255349726
  NPD
• Charleston Treatment Center, LLC

  • Methadone Clinic
  • Charleston, WV
  • NPI 1861906687
  NPD (past)

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

{
    "created_epoch": "1549324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549324800000",
    "number": "1174088058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 CORBIN HEIGHTS CIR",
            "city": "GIVEN",
            "state": "WV",
            "postal_code": "252458072",
            "telephone_number": "304-532-4463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 CORBIN HEIGHTS CIR",
            "city": "GIVEN",
            "state": "WV",
            "postal_code": "252458072",
            "telephone_number": "304-532-4463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURDETTE",
        "first_name": "BOBBIE",
        "middle_name": "JO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-05",
        "last_updated": "2019-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "APRN44075NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Boggess
• Elizabeth Cobb
• Emily Rose Fields
• Lisa Fisher-Medford
• Tammy Lynn Harper
• Kilee Jackson

• Family Nurse Practitioner in Given, WV
• Providers in Given, WV by specialty
• Family Nurse Practitioner in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2019; 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.