Individual provider Active NPI

Jean Ann Burbach, RXN,CNS

  • Psychiatric/Mental Health Nurse Practitioner
  • Colorado Springs, CO
National Provider Identifier
1366494478
Registry record updated Jan 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
90570 Issued in CO
Practice address
514 Observatory Dr
Colorado Springs, CO 80904-3970
Phone
(719) 471-4049
Fax
(719) 471-2023
NPI assigned
May 17, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 6, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Clinical Nurse Specialist 364SP0808X 9836 CO
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 90570 CO Primary

Addresses

Primary practice location

514 Observatory Dr
Colorado Springs, CO 80904-3970

Mailing address

514 Observatory Dr
Colorado Springs, CO 80904-3970
Phone (719) 471-4049

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20160316001055 CO Practitioner - Certified Clinical Nurse Specialist (CNS) 0749586832 Practice locations: Colorado Springs, CO

Care Compare profile

Medicare Care Compare
Specialty
Certified Clinical Nurse Specialist (CNS)
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

514 Observatory Dr
Colorado Springs, CO 80904-3970
Phone (719) 471-4049

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Specialist

State licenses

LicenseStateTypeSpecialty
90570COMDPsychiatric/Mental Health Nurse Practitioner
9836COMDPsychiatric/Mental Health Clinical Nurse Specialist

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736121600000",
    "number": "1366494478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "514 OBSERVATORY DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809043970",
            "telephone_number": "719-471-4049",
            "fax_number": "719-471-2023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "514 OBSERVATORY DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809043970",
            "telephone_number": "719-471-4049",
            "fax_number": "719-471-2023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURBACH",
        "first_name": "JEAN",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "RXN,CNS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-17",
        "last_updated": "2025-01-06",
        "certification_date": "2025-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0808X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": "CO",
            "license": "9836",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CO",
            "license": "90570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.