James Kennedy Burke, PH.D.
Individual provider Active NPI Clinical Psychologist · Payneville, KY
NPI 1295799310 · NPPES record last updated Sep 12, 2024
Key facts
- NPI
- 1295799310
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 0715 (KY)
- Practice address
- 257 Watson Rd
Payneville, KY 40157 - Phone
- (270) 497-4840
- Fax
- (270) 497-4841
- NPI assigned
- Apr 14, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 4
Medicare Care Compare profile
- Specialty
- Clinical Psychologist
- Education
- Other, 1988
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
257 Watson Rd
Payneville, KY 40157-7625
Phone (270) 497-4840
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20071010000655 | KY | Practitioner - Clinical Psychologist | 6406942192 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0715 | KY | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Communicare Inc | Past | Accepting new patients | |
| Communicare Inc | Past | Accepting new patients | |
| Communicare Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 0715 | KY | Yes |
Addresses
Primary practice location
257 Watson Rd
Payneville, KY 40157
Mailing address
257 Watson Rd
Payneville, KY 40157
Phone (270) 351-5505
Other providers in Payneville, KY
All providers in Payneville, KY · Clinical Psychologist in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 12, 2024. 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).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.