Active NPI
Adam Burke
- Registered Nurse
- White City, OR
National Provider Identifier
1215776604
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 202205024RN
- Practice address
- 8495 Crater Lake Hwy
White City, OR 97503-3011 - Phone
- (218) 670-0458
- NPI assigned
- May 23, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Registered Nurse | 163WC1500X | 202205024RN | OR | |
| Registered Nurse | 163W00000X | 202205024RN | OR | Primary |
Addresses
Primary practice location
8495 Crater Lake Hwy
White City, OR 97503-3011
Mailing address
404 3Rd St NE
Fulda, MN 56131-1210
Phone (218) 670-0458
Other practice location 1
2200 Bryant Williams Dr Ste 7
Klamath Falls, OR 97601-1121
Phone (218) 670-0458
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 202205024RN | OR | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1716422400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1716422400000",
"number": "1215776604",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "404 3RD ST NE",
"city": "FULDA",
"state": "MN",
"postal_code": "561311210",
"telephone_number": "218-670-0458"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8495 CRATER LAKE HWY",
"city": "WHITE CITY",
"state": "OR",
"postal_code": "975033011",
"telephone_number": "218-670-0458"
}
],
"practiceLocations": [
{
"address_1": "2200 Bryant Williams Dr Ste 7",
"address_purpose": "LOCATION",
"city": "Klamath Falls",
"state": "OR",
"postal_code": "976011121",
"country_code": "US",
"telephone_number": "218-670-0458",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BURKE",
"first_name": "ADAM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-05-23",
"last_updated": "2024-05-23",
"certification_date": "2024-05-23",
"status": "A"
},
"taxonomies": [
{
"code": "163WC1500X",
"taxonomy_group": "",
"desc": "Registered Nurse, Community Health",
"state": "OR",
"license": "202205024RN",
"primary": false
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "OR",
"license": "202205024RN",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in White City, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.