Individual provider Active NPI

Nancy Marie Burgess, ANPC

  • Family Nurse Practitioner
  • Medford, OR
National Provider Identifier
1245308832
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
200750134NP Issued in OR
Practice address
3617 S Pacific Hwy
Medford, OR 97501-8957
Phone
(541) 535-6239
Fax
(541) 512-1026
NPI assigned
Dec 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 649948 TX
Family Nurse Practitioner 363LF0000X 200750134NP OR Primary

Addresses

Primary practice location

3617 S Pacific Hwy
Medford, OR 97501-8957

Mailing address

3617 S Pacific Hwy
Medford, OR 97501-8957
Phone (541) 535-6239

Other identifiers 2

IdentifierTypeStateIssuer
200750134NPOtherOROREGON STATE LICENSE
649948OtherTXREGISTERED NURSE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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

Enrollment IDStateProvider typePAC IDDetails
I20080227000814 OR Practitioner - Nurse Practitioner 7416988050 Reassigns benefits to 1 organization
Practice locations: Redmond, OR

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Doctors Emergency Room Corp PCGroup PAC ID 2668467317, 20 clinicians

Practice addresses (Care Compare)

1460 G St
Springfield, OR 97477-4112
Phone (541) 726-4400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
649948TXMDRegistered Nurse
200750134NPORMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Doctors Emergency Room Corp PC CurrentSince Nov 1, 2020 Accepting new patients
Nancy M Burgess RN MSN Anp-C PC PastSince Nov 17, 2011 Accepting new patients
Michael V Abene MD PA PastSince Aug 1, 2012 Accepting new patients
John K Ross, MD PC Past Accepting new patients
Todd J Swick, MD, PA PastSince Feb 1, 2002 Accepting new patients

Locations

1460 G St
Springfield, OR 97477
Phone (541) 431-0665

Interoperability endpoints

  • Direct secure messaging: nburgess@yourcarecommunity.org
  • FHIR API: https://api.platform.athenahealth.com/1804/brand/1/csg/1/fhir/r4
  • Direct secure messaging: nancy.burgess@377425910366212.direct.elationemr.com

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1245308832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3617 S PACIFIC HWY",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975018957",
            "telephone_number": "541-535-6239",
            "fax_number": "541-512-1026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3617 S PACIFIC HWY",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975018957",
            "telephone_number": "541-535-6239",
            "fax_number": "541-512-1026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURGESS",
        "first_name": "NANCY",
        "middle_name": "MARIE",
        "credential": "ANPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-01",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "649948",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "200750134NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OREGON STATE LICENSE",
            "identifier": "200750134NP",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED NURSE LICENSE",
            "identifier": "649948",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

Verify at the official NPI Registry.