Malia Alys Burgess, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA-12149 Issued in CO

Practice address

12400 High Bluff Dr
San Diego, CA 92130-3077

Phone

(866) 871-8519

NPI assigned

Jun 26, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1340668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340668800000",
    "number": "1285998195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2125 CLEARVIEW AVE",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805214209",
            "telephone_number": "360-201-8573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12400 HIGH BLUFF DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921303077",
            "telephone_number": "866-871-8519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURGESS",
        "first_name": "MALIA",
        "middle_name": "ALYS",
        "name_prefix": "Miss",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-26",
        "last_updated": "2012-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WA",
            "license": "P160043572",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CO",
            "license": "PTA-12149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alana Burges
• Benjamin Nathaniel Burgess, MD
• Gail Marie Burgess, DMD
• Jennifer Burgess, NP
• Lloyd G Burgess, M.D.
• Margaret Lois Gurman Burgess, LCSW
• Matthew Daniel Burgess, MD
• Spencer Burgess
• Toni Burgess
• Burgett Dental Corporation

• Physical Therapy Assistant in San Diego, CA
• Providers in San Diego, CA by specialty
• Physical Therapy Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 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.