Gary R. Burgess, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA9103396 Issued in FL

Practice address

4621 Emerson St
Jacksonville, FL 32207-4920

Phone

(904) 399-8884

NPI assigned

Apr 18, 2007

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194942748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1895 SENTRY OAK CT",
            "city": "GREEN COVE SPRINGS",
            "state": "FL",
            "postal_code": "320433775",
            "telephone_number": "904-284-4190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4621 EMERSON ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322074920",
            "telephone_number": "904-399-8884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURGESS",
        "first_name": "GARY",
        "middle_name": "R.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9103396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amber Deann Burgbacher, APRN
• Charles Burger, MD
• John Burger, M.D.
• Conekia Marshea Burgess, MSN RN APRN FNP-C
• Eddy D Burgess, CRNA
• James Burgess, M.B.B.S.
• Janelle Burgess, MPH
• Latasha R Burgess
• Lyza Julliet Burgess, APRN
• Nasheed Burgess, PA-C

• Medical Physician Assistant in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Medical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.