Kelly Burke, NURSE PRACTITIONER
Individual provider Active NPI Primary Care Nurse Practitioner · Taunton, MA
NPI 1346852019 · NPPES record last updated Nov 9, 2021
Key facts
- NPI
- 1346852019
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Primary Care Nurse Practitioner 363LP2300X
- License
- RN2283637 (MA)
- Practice address
- 1 Washington St
Taunton, MA 02780-3960 - Phone
- (150) 882-2550
- NPI assigned
- Aug 23, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 9
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Manet Community Health Center, Inc.
Practice addresses (Care Compare)
110 W Squantum St
Quincy, MA 02171-2122
Phone (617) 376-3000
Hospital & facility affiliations
- Nightingale Visiting Nurses
- Brown University Health Morton Hospital
- Sturdy Memorial Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210922001902 | MA | Practitioner - Nurse Practitioner | 6507263266 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Manet Community Health Center, Inc. | Current |
Accepting new patients | |
| Manet Community Health Center, Inc. | Current |
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
- https://api.platform.athenahealth.com/4368/brand/1/csg/1/fhir/r4
- kelly.burke.1@4368.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Nurse Practitioner | 363LP2300X | RN2283637 | MA | Yes |
Addresses
Primary practice location
1 Washington St
Taunton, MA 02780-3960
Mailing address
1 Washington St
Taunton, MA 02780-3960
Phone (508) 822-5500
NPI Registry JSON
{
"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
- Scarlett Buer
- Jennifer A Buker
- Valerie Bulgaris
- Kaitlyn Elizabeth Bullock
- Heidi Marie Burgo
- Sean Burke
- Mildred Rose Burrows
- Brittney Burt
- Emily Anne Bush
- Katelyne Bushe
All providers in Taunton, MA · Primary Care Nurse Practitioner in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 9, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.