Carolyn Vernez Burcham, NP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AP8440 Issued in AZ

Practice address

8836 N 23Rd Ave
B1
Phoenix, AZ 85021-4185

Phone

(602) 944-9810

Fax

(602) 216-7040

NPI assigned

Aug 15, 2006

Last updated

Dec 5, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Interoperability endpoints

• Direct secure messaging: carolyn.burcham.p1@direct.terros.nextgenshare.com

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480896000000",
    "number": "1306859798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3003 N CENTRAL AVE",
            "address_2": "SUITE 200",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122902",
            "telephone_number": "602-685-6000",
            "fax_number": "602-302-7925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8836 N 23RD AVE",
            "address_2": "B1",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850214185",
            "telephone_number": "602-944-9810",
            "fax_number": "602-216-7040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURCHAM",
        "first_name": "CAROLYN",
        "middle_name": "VERNEZ",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-15",
        "last_updated": "2016-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "664148",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "664148",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "AP8440",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "117941",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Evan Burch
• Kevin Burch
• Madison Burch
• Sarah Burch
• Alexandra Haley Burcham
• Sarah M Burchard, RBT
• Rebecca Burdi, PMHNP
• Alissa Brook Burg
• Haylie C Burg
• Jerrod Burgan

• Psychiatric/Mental Health Nurse Practitioner in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Psychiatric/Mental Health Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.