NPIMap

Individual provider Active NPI

Jill Diane Burkley, PSY D

  • Psychologist
  • Mason City, IA
National Provider Identifier
1376550988
Registry record updated Jul 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
00982 Issued in IA
Practice address
1000 4TH Street SW
Mason City, IA 50401-1562
Phone
(641) 422-7797
Fax
(641) 428-7516
NPI assigned
Aug 3, 2006
Last updated
Jul 15, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 00982 IA Primary

Addresses

Primary practice location

1000 4TH Street SW
Mason City, IA 50401-1562

Mailing address

1000 4TH St SW
Mason City, IA 50401-2800
Phone (641) 422-7797

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jburkley3941168@direct.trinity-health.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050222000758 IA Practitioner - Clinical Psychologist 0143273839 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Iowa Mercy ClinicsGroup PAC ID 7810809076, 304 clinicians

Practice addresses (Care Compare)

1000 4TH St SW
Mason City, IA 50401-2800

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.55 of 100Reported as group
Quality
73.89
Promoting interoperability
93
Improvement activities
40
Cost
70.44

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
00982IAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
North Iowa Mercy Clinics CurrentSince Apr 2, 2012 Accepting new patients
North Iowa Mercy Clinics Current Accepting new patients
North Iowa Mercy Clinics CurrentSince Apr 2, 2012 Accepting new patients
Mercy Health Services-Iowa Corp Past Accepting new patients
North Iowa Mercy Clinics Past Accepting new patients
Wellsource Psychologist PastSince Jul 1, 2011 Accepting new patients

Locations

1000 4th St SW
Mason City, IA 50401
Phone (641) 424-6704

1000 4th St SW
Ste Bs
Mason City, IA 50401
Phone (641) 422-7797

Interoperability endpoints

  • Direct secure messaging: jburkley3941168@direct.trinity-health.org

Organizations & group practices 6

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 1

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": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752537600000",
    "number": "1376550988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 4TH ST SW",
            "city": "MASON CITY",
            "state": "IA",
            "postal_code": "504012800",
            "telephone_number": "641-422-7797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 4TH STREET SW",
            "city": "MASON CITY",
            "state": "IA",
            "postal_code": "504011562",
            "telephone_number": "641-422-7797",
            "fax_number": "641-428-7516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURKLEY",
        "first_name": "JILL",
        "middle_name": "DIANE",
        "name_prefix": "Dr.",
        "credential": "PSY D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-03",
        "last_updated": "2025-07-15",
        "certification_date": "2025-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IA",
            "license": "00982",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jburkley3941168@direct.trinity-health.org",
            "affiliation": "N",
            "endpointDescription": "MercyOne North Iowa Direct Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "1000 4th Street SW",
            "city": "Mason City",
            "state": "IA",
            "country_code": "US",
            "postal_code": "504011562",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mason City, IA

Sources for this page

Verify at the official NPI Registry.