Jennifer Ashley Burroughs, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5594 Issued in TN

Practice address

490 Dunlop LN
Clarksville, TN 37040-5007

Phone

(931) 245-7000

NPI assigned

Jun 15, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TN

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

Specialty

Physician Assistant

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Premier Medical Group PCGroup PAC ID 9739084088, 46 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Interoperability endpoints

• Direct secure messaging: jennifer.burroughs.1@7977.direct.athenahealth.com

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.

• Premier Medical Group PC

  • General Practice Physician
  • Clarksville, TN
  • NPI 1740242957
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1686787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698278400000",
    "number": "1184309429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3799",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370433799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "490 DUNLOP LN",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370405007",
            "telephone_number": "931-245-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURROUGHS",
        "first_name": "JENNIFER",
        "middle_name": "ASHLEY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-15",
        "last_updated": "2023-10-26",
        "certification_date": "2023-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "5594",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jennifer.burroughs.1@7977.direct.athenahealth.com",
            "affiliation": "Y",
            "affiliationName": "Premier Medical Group PC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "490 Dunlop Ln",
            "city": "Clarksville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "370405007",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Anne Marie Burlingame, BEHAVIOR TECHNICIAN
• Kyle Matthew Burner, M.D.
• Ashley Burnett, BCBA, LBA
• Vicki Elaine Burnette-Bailey, BA
• Makenzie Burns
• Ainez Burrus
• Elizabeth Kathleen Burton, MSN, PMHNP-BC
• Ginger Burton, RN
• Patricia Burton
• Kelly Jean Burwell, D.C.

• Physician Assistant in Clarksville, TN
• Providers in Clarksville, TN by specialty
• Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.