Integrated Psychogenic Wellness Associates

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

210912 Issued in NC

Legal business name

INTEGRATED PSYCHOGENIC WELLNESS ASSOCIATES

Practice address

1205 W Bessemer Ave # 1213
Greensboro, NC 27408-8442

Phone

(336) 736-1452

NPI assigned

May 15, 2018

Organization subpart

No

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

Authorized official

Name

Evanna Burkett, RN, FNP-C, DNPNPI 1255504742

Title

Nurse Practitioner

Phone

(336) 736-1452

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Evanna Corrin Burkett, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Leesburg, VA
  • NPI 1255504742
  NPD Authorized official

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

{
    "created_epoch": "1526342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1526342400000",
    "number": "1184114118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2672 SPLITBROOK DR",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272657980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 W BESSEMER AVE # 1213",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274088442",
            "telephone_number": "336-736-1452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED PSYCHOGENIC WELLNESS ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-15",
        "last_updated": "2018-05-15",
        "status": "A",
        "authorized_official_last_name": "BURKETT",
        "authorized_official_first_name": "EVANNA",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "336-736-1452",
        "authorized_official_credential": "RN, FNP-C, DNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "210912",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1255504742",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Instride Foot and Ankle Specialists, PLLC
• Integrated Behavioral Health Solutions PLLC
• Integrated Community Healthcare, Inc.
• Integrated Healthcare Solutions of NC LLC
• Integrated Medicine of Greenboro
• Integrative Behavioral Health & Healing Practice PLLC
• Integrative Psychiatric Care PLLC
• Integrative Therapies, Inc.
• Integrative Therapies, Inc.
• Intellichoice Staffing LLC

• Psychiatric/Mental Health Nurse Practitioner in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Psychiatric/Mental Health Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2018; 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.