Tara L Burkett

Primary specialty

SpecialistTaxonomy code 174400000X

License

109811 Issued in TX

Practice address

2425 E Southlake Blvd
#100
Southlake, TX 76092-6674

Phone

(817) 442-0222

Fax

(817) 442-0223

NPI assigned

Nov 6, 2012

Last updated

Nov 6, 2012By the provider in NPPES

Sex

Female

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

Practice roles

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.

• Pediaplex Management Company LLC

  • Speech-Language Pathologist
  • Southlake, TX
  • NPI 1821374687
  NPD (past)

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

{
    "created_epoch": "1352160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352160000000",
    "number": "1255685632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2425 E SOUTHLAKE BLVD",
            "address_2": "#100",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926674",
            "telephone_number": "817-442-0222",
            "fax_number": "817-442-0223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2425 E SOUTHLAKE BLVD",
            "address_2": "#100",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926674",
            "telephone_number": "817-442-0222",
            "fax_number": "817-442-0223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURKETT",
        "first_name": "TARA",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-06",
        "last_updated": "2012-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TX",
            "license": "109811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathy Kim Bui
• Built 4 It Athletics (Built 4 It Southlake)
• Bull Care, PLLC
• Joanna Bullock, MSPT
• Mia Chikita Burgan, MA, LPC
• Charity Joy Burkhardt, PA
• Melanie Ann Burman, LCSW
• Mariah Fiorillo Burnell, D.O.
• Catherine Word Burton, M.A., LPC, LMFT
• Stacie Lynn Bussey, RNFA

• Specialist in Southlake, TX
• Providers in Southlake, TX by specialty
• Specialist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2012; 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.