Ronnie Burak, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY0004593 Issued in FL

Practice address

482 Jacksonville Dr
Jacksonville Beach, FL 32250-3812

Phone

(904) 247-3600

Fax

(904) 247-4926

NPI assigned

Aug 28, 2006

Sex

Female

Sole proprietor

Yes

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

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jul 1, 2012 through Jul 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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 and National Provider Directory roles.

• David C Blackmon,PHD,Psych SVC

  • Clinical Neuropsychologist
  • Jacksonville Beach, FL
  • NPI 1538438270
  NPD (past)
• George M Joseph MD PA

  • Psychiatry Physician
  • Jacksonville Beach, FL
  • NPI 1770753311
  NPD (past)

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

{
    "created_epoch": "1156723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295843464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "482 JACKSONVILLE DR",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322503812",
            "telephone_number": "904-247-3600",
            "fax_number": "904-247-4926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "482 JACKSONVILLE DR",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322503812",
            "telephone_number": "904-247-3600",
            "fax_number": "904-247-4926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURAK",
        "first_name": "RONNIE",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY0004593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea N Buck, DPT
• Anne Thu-Anh Bui, MD
• Hong Tu Bui, PHAMD
• Kelly M Bumgarner, PA-C
• Carl Burak, M.D.
• Isabella Quintero Burchett, DPT
• Madison Lee Burger
• Timothy F. Burkhart, P.T.
• Brian Craig Burnett, D.C.
• Dana L Burnette, LCSW

• Clinical Psychologist in Jacksonville Beach, FL
• Providers in Jacksonville Beach, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.