Individual provider Active NPI

Kelly Burke, NURSE PRACTITIONER

  • Primary Care Nurse Practitioner
  • Taunton, MA
National Provider Identifier
1346852019
Registry record updated Nov 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
RN2283637 Issued in MA
Practice address
1 Washington St
Taunton, MA 02780-3960
Phone
(150) 882-2550
NPI assigned
Aug 23, 2020
Last updated
Nov 9, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X RN2283637 MA Primary

Addresses

Primary practice location

1 Washington St
Taunton, MA 02780-3960

Mailing address

1 Washington St
Taunton, MA 02780-3960
Phone (508) 822-5500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210922001902 MA Practitioner - Nurse Practitioner 6507263266 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

110 W Squantum St
Quincy, MA 02171-2122
Phone (617) 376-3000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Manet Community Health Center, Inc. CurrentSince Aug 30, 2021 Accepting new patients
Manet Community Health Center, Inc. CurrentSince Aug 30, 2021 Accepting new patients
Manet Community Health Center, Inc. Past Accepting new patients

Locations

110 W Squantum St
Quincy, MA 02171
Phone (617) 376-3000

1 Washington St
Taunton, MA 02780
Phone (508) 828-9116

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/4368/brand/1/csg/1/fhir/r4
  • Direct secure messaging: kelly.burke.1@4368.direct.athenahealth.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1598140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636416000000",
    "number": "1346852019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 WASHINGTON ST",
            "city": "TAUNTON",
            "state": "MA",
            "postal_code": "027803960",
            "telephone_number": "508-822-5500",
            "fax_number": "508-822-5501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 WASHINGTON ST",
            "city": "TAUNTON",
            "state": "MA",
            "postal_code": "027803960",
            "telephone_number": "150-882-2550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURKE",
        "first_name": "KELLY",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-23",
        "last_updated": "2021-11-09",
        "certification_date": "2021-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MA",
            "license": "RN2283637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Taunton, MA

Sources for this page

Verify at the official NPI Registry.