Individual provider Active NPI

Jacqueline Renae Burgess, LM, CPM

  • Midwife
  • Reno, NV
National Provider Identifier
1326415951
Registry record updated May 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
MidwifeTaxonomy code 176B00000X
License
LM661 Issued in CA
Practice address
7693 S. Virginia St.
Reno, NV 89511-1114
Phone
(775) 480-9241
Fax
(775) 418-0430
NPI assigned
Aug 31, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Midwife 176B00000X LM661 CA Primary

Addresses

Primary practice location

7693 S. Virginia St.
Reno, NV 89511-1114

Mailing address

7693 S. Virginia St.
Reno, NV 89511-1114
Phone (239) 699-8718

Other names 1

  • Jackie Renae Crane Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LM661CAMDMidwife

Practice roles

OrganizationSpecialtyStatusNew patients
Edge Medical Services Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1440979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747699200000",
    "number": "1326415951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7693 S. VIRGINIA ST.",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895111114",
            "telephone_number": "239-699-8718",
            "fax_number": "775-418-0430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7693 S. VIRGINIA ST.",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895111114",
            "telephone_number": "775-480-9241",
            "fax_number": "775-418-0430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURGESS",
        "first_name": "JACQUELINE",
        "middle_name": "RENAE",
        "name_prefix": "Ms.",
        "credential": "LM, CPM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-31",
        "last_updated": "2025-05-20",
        "certification_date": "2025-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "CA",
            "license": "LM661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACKIE",
            "last_name": "CRANE",
            "middle_name": "RENAE",
            "credential": "LM, CPM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Reno, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2025; 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.