Individual provider Active NPI

Diane Arnold Burks, M.S.

  • Clinical Social Worker
  • Indianapolis, IN
National Provider Identifier
1396765137
Registry record updated May 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34002013A Issued in IN
Practice address
618 N High School Rd
Indianapolis, IN 46214-3684
Phone
(317) 381-0355
Fax
(317) 381-0356
NPI assigned
Jul 21, 2006
Last updated
May 6, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 34002013A IN Primary
Marriage & Family Therapist 106H00000X 35000741A IN

Addresses

Primary practice location

618 N High School Rd
Indianapolis, IN 46214-3684

Mailing address

618 N High School Rd
Indianapolis, IN 46214-3684
Phone (317) 381-0355

Other identifiers 4

IdentifierTypeStateIssuer
100177270MedicaidIN
292726000OtherINMAGELLAN
7437447OtherINAETNA
000000222728OtherINANTHEM PPO, TRADITIONAL

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
34002013AINMDClinical Social Worker
35000741AINMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Indianapolis Institute for Families, Inc. Clinical Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210032000000",
    "number": "1396765137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "618 N HIGH SCHOOL RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462143684",
            "telephone_number": "317-381-0355",
            "fax_number": "317-381-0356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "618 N HIGH SCHOOL RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462143684",
            "telephone_number": "317-381-0355",
            "fax_number": "317-381-0356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURKS",
        "first_name": "DIANE",
        "middle_name": "ARNOLD",
        "name_prefix": "Ms.",
        "credential": "M.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-21",
        "last_updated": "2008-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34002013A",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IN",
            "license": "35000741A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100177270",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "292726000",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7437447",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PPO, TRADITIONAL",
            "identifier": "000000222728",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2008; 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.