Individual provider Active NPI

Jodie Lynn Burriss, FNP

  • Family Nurse Practitioner
  • Lubbock, TX
National Provider Identifier
1386944817
Registry record updated Dec 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
671024 Issued in TX
Practice address
4404 19TH St
Suite C
Lubbock, TX 79407-2424
Phone
(806) 795-8150
Fax
(806) 791-6688
NPI assigned
Nov 1, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 671024 TX Primary

Addresses

Primary practice location

4404 19TH St
Suite C
Lubbock, TX 79407-2424

Mailing address

3420 22ND PL
Lubbock, TX 79410-1314
Phone (806) 725-5844

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20110215000136 TX Practitioner - Nurse Practitioner 2860672441 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
671024TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Medical Group CurrentSince Dec 1, 2011 Accepting new patients
Covenant Medical Group CurrentSince Dec 1, 2011 Accepting new patients
Consultants in Infectious Diseases Past Accepting new patients
Consultants in Infectious Diseases Past Accepting new patients

Locations

4404 19th St
Ste C
Lubbock, TX 79407
Phone (806) 795-8150

2215 Nashville Ave
Lubbock, TX 79410
Phone (806) 725-5228

3420 22nd Pl
Lubbock, TX 79410
Phone (806) 725-1800

4102 24th St
Ste 403
Lubbock, TX 79410
Phone (806) 725-7150

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/0afb6793-ac40-40a5-8123-d13a308d2792/
  • Direct secure messaging: jburriss1928948@oc.providencedirect.org
  • FHIR API: https://api.platform.athenahealth.com/18668/brand/1/csg/1/fhir/r4

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1288569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322697600000",
    "number": "1386944817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3420 22ND PL",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101314",
            "telephone_number": "806-725-5844",
            "fax_number": "806-723-6532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4404 19TH ST",
            "address_2": "SUITE C",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794072424",
            "telephone_number": "806-795-8150",
            "fax_number": "806-791-6688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURRISS",
        "first_name": "JODIE",
        "middle_name": "LYNN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-01",
        "last_updated": "2011-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "671024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

Verify at the official NPI Registry.