Jennifer Burgtorf

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

4704286508 Issued in MI

Practice address

25000 Hall Rd Ste 1
Woodhaven, MI 48183-5112

Phone

(734) 676-3373

NPI assigned

Aug 16, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

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.

• Main Street Physicians P.C.

  • Internal Medicine Physician
  • Woodhaven, MI
  • NPI 1952866808
  Medicare reassignment NPD
• Baco Care Services LLC

  • Internal Medicine Physician
  • Southfield, MI
  • NPI 1780294850
  NPD

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

{
    "created_epoch": "1439683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728432000000",
    "number": "1205202025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25000 HALL RD",
            "address_2": "STE 1",
            "city": "WOODHAVEN",
            "state": "MI",
            "postal_code": "481835112",
            "telephone_number": "734-676-3373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25000 HALL RD STE 1",
            "city": "WOODHAVEN",
            "state": "MI",
            "postal_code": "481835112",
            "telephone_number": "734-676-3373"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9049 Bellevue Rd",
            "address_purpose": "LOCATION",
            "city": "Grosse Ile",
            "state": "MI",
            "postal_code": "481381858",
            "country_code": "US",
            "telephone_number": "734-676-3373",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURGTORF",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-16",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MI",
            "license": "4704286508",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MI",
            "license": "4704286508",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MI",
            "license": "4704286508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Judith Lynn Briggs, OTR
• Matthew Briscoe
• Cory Buckner
• Emily Marie Buehner, DDS
• Lauren Marie Bullard, PA-C
• Angela Burley, LMSW
• Damon A Busby, CPHT
• Catherine Ann Campbell, LLMSW
• Careguard Home Safety LLC
• Carolin Ibrahim DDS MSD PLLC (Everest Endodontics)

• Primary Care Nurse Practitioner in Woodhaven, MI
• Providers in Woodhaven, MI by specialty
• Primary Care Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2024; 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.