Individual provider Active NPI

Samondria Burger, LPN

  • Licensed Practical Nurse
  • Dublin, GA
National Provider Identifier
1376284513
Registry record updated Apr 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
100730 Issued in GA
Practice address
1826 Veterans Blvd
Dublin, GA 31021-3620
Phone
(478) 272-1210
NPI assigned
Apr 3, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 100730 GA Primary

Addresses

Primary practice location

1826 Veterans Blvd
Dublin, GA 31021-3620

Mailing address

205 Merlin St
East Dublin, GA 31027-7362
Phone (478) 353-9632

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
100730GAMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1648944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648944000000",
    "number": "1376284513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 MERLIN ST",
            "city": "EAST DUBLIN",
            "state": "GA",
            "postal_code": "310277362",
            "telephone_number": "478-353-9632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1826 VETERANS BLVD",
            "city": "DUBLIN",
            "state": "GA",
            "postal_code": "310213620",
            "telephone_number": "478-272-1210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURGER",
        "first_name": "SAMONDRIA",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-03",
        "last_updated": "2022-04-03",
        "certification_date": "2022-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "GA",
            "license": "100730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dublin, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2022; 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.