Fred Albert Burnett IV, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AL2718 Issued in FL

Practice address

1 Unf Dr
Jacksonville, FL 32224-7699

Phone

(904) 620-1500

NPI assigned

Oct 31, 2011

Last updated

Oct 31, 2011By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• University of North Florida Student Medical Service

  • Student Health Clinic/Center
  • Jacksonville, FL
  • NPI 1730418641
  NPD (past)

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

{
    "created_epoch": "1320019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320019200000",
    "number": "1396021739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5929 ORCHARD POND DR",
            "city": "FLEMING ISLAND",
            "state": "FL",
            "postal_code": "320038308",
            "telephone_number": "904-278-3057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 UNF DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322247699",
            "telephone_number": "904-620-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURNETT",
        "first_name": "FRED",
        "middle_name": "ALBERT",
        "name_prefix": "Mr.",
        "name_suffix": "IV",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-10-31",
        "last_updated": "2011-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "FL",
            "license": "AL2718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas George Burnakis, PHARM.D.
• Ashley Burneko, CRNA
• Angela Renee Burnett, NP
• Ericka Burnett, APRN
• Erin Hale Burnett, MD
• Jeanpaul Margain Burnett, PHARMD
• Omer Lee Burnett Jr., M.D.
• Rebecca Elizabeth Burnett, PT, DPT
• Marrow Burnette, PT, MSPT, OCS, COMT
• Ileish Burney, APRN

• Athletic Trainer in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Athletic Trainer in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2011; 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.