Wanda G Burdette, P.A.-C.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

509 Issued in WV

Practice address

4605 Maccorkle Ave SW
South Charleston, WV 25309-1311

Phone

(304) 414-4800

NPI assigned

Apr 23, 2008

Sex

Female

Sole proprietor

No

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

Green means eligible to order or refer.

Merit-based Incentive Payment System (MIPS)

Final score

95.34 of 100Reported as apm

Quality

79.86

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Charleston Surgical Hospital Healthcare Group, PLLC

  • Surgery Physician
  • Charleston, WV
  • NPI 1285131144
  NPD (past)
• Emergency Medicine Physicians of Kanawha County, PLLC

  • Emergency Medicine Physician
  • South Charleston, WV
  • NPI 1326087289
  NPD (past)
• Gilbert Goliath MD PLLC

  • Specialist
  • South Charleston, WV
  • NPI 1700126257
  NPD (past)

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

{
    "created_epoch": "1208908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672531200000",
    "number": "1316112030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4605 MACCORKLE AVE SW",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "253091311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4605 MACCORKLE AVE SW",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "253091311",
            "telephone_number": "304-414-4800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "333 Laidley St Fl 2W",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "WV",
            "postal_code": "253011614",
            "country_code": "US",
            "telephone_number": "304-347-6116",
            "fax_number": "304-347-6117",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURDETTE",
        "first_name": "WANDA",
        "middle_name": "G",
        "credential": "P.A.-C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-23",
        "last_updated": "2023-01-01",
        "certification_date": "2023-01-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WV",
            "license": "509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Renee Burdette
• Jessica Burdette, RN
• Michelle R Burdette, MD, RETIRED
• Raina Burdette
• Rochelle Burdette
• Madison Burdine
• Kristen Burford
• Rikki Burford
• Heidi Burgess
• Danielle Jasmise Burkes

• Physician Assistant in South Charleston, WV
• Providers in South Charleston, WV by specialty
• Physician Assistant in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 1, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.