Individual provider Active NPI

Dana K. Burden

  • Nurse's Aide
  • Lake Village, AR
National Provider Identifier
1336793199
Registry record updated Jul 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse's AideTaxonomy code 376K00000X
License
050595920816R Issued in AR
Practice address
891 Connerly Rd
Lake Village, AR 71653-6163
Phone
(870) 265-1301
NPI assigned
Jul 30, 2019
Last updated
Jul 30, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 30, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Aide 374U00000X 05059592081R AR
Nurse's Aide 376K00000X 050595920816R AR Primary

Addresses

Primary practice location

891 Connerly Rd
Lake Village, AR 71653-6163

Mailing address

891 Connerly Rd
Lake Village, AR 71653-6163
Phone (870) 265-1301

Other practice location 1

891 Connerly Rd
Lake Village, AR 71653-6163
Phone (870) 265-1301

Other practice location 2

891 Connerly Rd
Lake Village, AR 71653-6163
Phone (870) 265-1301

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
05059592081RARMDHome Health Aide
050595920816RARMDNurse's Aide

NPI Registry JSON

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

{
    "created_epoch": "1564444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564444800000",
    "number": "1336793199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "891 CONNERLY RD",
            "city": "LAKE VILLAGE",
            "state": "AR",
            "postal_code": "716536163",
            "telephone_number": "870-265-1301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "891 CONNERLY RD",
            "city": "LAKE VILLAGE",
            "state": "AR",
            "postal_code": "716536163",
            "telephone_number": "870-265-1301"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "891 Connerly Rd",
            "address_purpose": "LOCATION",
            "city": "Lake Village",
            "state": "AR",
            "postal_code": "716536163",
            "country_code": "US",
            "telephone_number": "870-265-1301",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "891 Connerly Rd",
            "address_purpose": "LOCATION",
            "city": "Lake Village",
            "state": "AR",
            "postal_code": "716536163",
            "country_code": "US",
            "telephone_number": "870-265-1301",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURDEN",
        "first_name": "DANA",
        "middle_name": "K.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-30",
        "last_updated": "2019-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "AR",
            "license": "05059592081R",
            "primary": false
        },
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "AR",
            "license": "050595920816R",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Village, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2019; 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.