Individual provider Active NPI

Greg Eugene Burleson, NURSE

  • Licensed Vocational Nurse
  • Lancaster, CA
National Provider Identifier
1336330562
Registry record updated Aug 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
171783 Issued in CA
Practice address
43423 Division St
Lancaster, CA 93535-4639
Phone
(661) 726-2850
Fax
(661) 726-2854
NPI assigned
Aug 5, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X 171783 CA Primary

Addresses

Primary practice location

43423 Division St
Lancaster, CA 93535-4639

Mailing address

3841 W Avenue K14
Lancaster, CA 93536-4903
Phone (661) 943-2997

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
171783CAMDLicensed Vocational Nurse

NPI Registry JSON

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

{
    "created_epoch": "1186272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186272000000",
    "number": "1336330562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3841 W AVENUE K14",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935364903",
            "telephone_number": "661-943-2997",
            "fax_number": "661-943-2997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43423 DIVISION ST",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935354639",
            "telephone_number": "661-726-2850",
            "fax_number": "661-726-2854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURLESON",
        "first_name": "GREG",
        "middle_name": "EUGENE",
        "name_prefix": "Mr.",
        "credential": "NURSE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-05",
        "last_updated": "2007-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "171783",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2007; 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.