Madison Brooke Burgess
Individual provider Active NPI Pediatric Nurse Practitioner · Crossville, TN
NPI 1275428633 · NPPES record last updated Oct 10, 2025
Key facts
- NPI
- 1275428633
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Nurse Practitioner 363LP0200X
- License
- 40056 (TN)
- Practice address
- 3234 Miller Ave
Crossville, TN 38555-6116 - Phone
- (931) 707-8700
- NPI assigned
- Jun 9, 2025
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260624000959 | TN | Order and Referring Only - Pediatric Medicine |
9032682877 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40056 | TN | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Plateau Pediatrics, PLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 40056 | TN | Yes |
Addresses
Primary practice location
3234 Miller Ave
Crossville, TN 38555-6116
Mailing address
3234 Miller Ave
Crossville, TN 38555-6116
Phone (931) 707-8700
Other practice location 1
9512 Cherokee Trl
Crossville, TN 38572-3577
Phone (931) 287-3731
Other names
- Madison Brooke Burgess
Other providers in Crossville, TN
- Shawn James Brunelle
- Ronald Brunk
- Selinda L Bryant
- Buckeye Home Health Center, Inc.
- Buckeye Home Health Center, Inc.
- Rodney Jerome Burney
- Sue W Burris
- Richard Matthew Buurman
- Pamela Mathews Cain
- Rachael Calhoun
All providers in Crossville, TN · Pediatric Nurse Practitioner in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 10, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.