Danny Ray Burgess, PHD

Individual provider Active NPI Clinical Psychologist · Jackson, MS

NPI 1346563137 · NPPES record last updated Aug 8, 2016

Key facts

NPI
1346563137
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Psychologist 103TC0700X
License
49854 (MS)
Practice address
1350 E Woodrow Wilson Ave
Jackson, MS 39216-5112
Phone
(601) 981-2611
NPI assigned
Mar 8, 2010
Sex
Male
Sole proprietor
Yes

Organizations & group practices 24

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.

Medicare Care Compare profile

Specialty
Clinical Psychologist
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
State of Mississippi - University of Mississippi Medical Center (956 clinicians)

Practice addresses (Care Compare)

2500 N State St
Jackson, MS 39216-4500
Phone (601) 815-4775

Merit-based Incentive Payment System (MIPS)

Final score
83.94 of 100 (group)
Quality
67.75
Promoting interoperability
100
Improvement activities
40
Cost
71.17

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20100922000151 MS Practitioner - Clinical Psychologist 1254457781 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
State of Mississippi - University of Mississippi Medical Center Current
since Jul 25, 2016
Accepting new patients
State of Mississippi - University of Mississippi Medical Center Current
since Jul 25, 2016
Accepting new patients
Mississippi Methodist Hospital & Rehabilitation Center, Inc. Past Accepting new patients

Locations

2500 N State St
Jackson, MS 39216
Phone (601) 815-4775

1350 E Woodrow Wilson Ave
Jackson, MS 39216
Phone (601) 364-5340

2500 N State St
Ste 4200
Jackson, MS 39216

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 49854 MS Yes

Addresses

Primary practice location

1350 E Woodrow Wilson Ave
Jackson, MS 39216-5112

Mailing address

1910 Lakeland Dr
Suite C
Jackson, MS 39216-5029
Phone (601) 713-1550

Other identifiers

IdentifierTypeStateIssuer
06359856MedicaidMS

Other providers in Jackson, MS

All providers in Jackson, MS · Clinical Psychologist in Mississippi

Sources for this page

Verify at the official NPI Registry.