Individual provider Active NPI

Elizabeth Burgess, RN-PMH-BC

  • Psychiatric/Mental Health Registered Nurse
  • Woodbury, NJ
National Provider Identifier
1285486274
Registry record updated Apr 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X
License
26NO11193500 Issued in NJ
Practice address
17 W Red Bank Ave Ste 302B
Woodbury, NJ 08096-1630
Phone
(856) 853-2020
Fax
(856) 221-4262
NPI assigned
Apr 3, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2024

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 26NO11193500 NJ
Case Management Registered Nurse 163WC0400X 26NO11193500 NJ
Child & Adolescent Psychiatric/Mental Health Registered Nurse 163WP0807X 26NO11193500 NJ
Adult Psychiatric/Mental Health Registered Nurse 163WP0809X 26NO11193500 NJ
Psychiatric/Mental Health Registered Nurse 163WP0808X 26NO11193500 NJ Primary

Addresses

Primary practice location

17 W Red Bank Ave Ste 302B
Woodbury, NJ 08096-1630

Mailing address

2585 London LN
Vineland, NJ 08361-7755
Phone (856) 853-2020

Other practice location 1

200 Rowan Blvd
Glassboro, NJ 08028-2260
Phone (856) 595-9115 ext. 42139

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

LicenseStateTypeSpecialty
26NO11193500NJMDPsychiatric/Mental Health Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Inspira Medical Centers, Inc. PastSince Apr 9, 2024 Accepting new patients

Organizations & group practices 1

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": "1712102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712102400000",
    "number": "1285486274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2585 LONDON LN",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083617755",
            "telephone_number": "856-853-2020",
            "fax_number": "856-221-4262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 W RED BANK AVE STE 302B",
            "city": "WOODBURY",
            "state": "NJ",
            "postal_code": "080961630",
            "telephone_number": "856-853-2020",
            "fax_number": "856-221-4262"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Rowan Blvd",
            "address_purpose": "LOCATION",
            "city": "Glassboro",
            "state": "NJ",
            "postal_code": "080282260",
            "country_code": "US",
            "telephone_number": "856-595-9115 x42139",
            "fax_number": "856-221-4262",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURGESS",
        "first_name": "ELIZABETH",
        "credential": "RN-PMH-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-03",
        "last_updated": "2024-04-03",
        "certification_date": "2024-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NJ",
            "license": "26NO11193500",
            "primary": false
        },
        {
            "code": "163WC0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Case Management",
            "state": "NJ",
            "license": "26NO11193500",
            "primary": false
        },
        {
            "code": "163WP0807X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Child & Adolescent",
            "state": "NJ",
            "license": "26NO11193500",
            "primary": false
        },
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "NJ",
            "license": "26NO11193500",
            "primary": false
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NO11193500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 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.

Verify at the official NPI Registry.