Individual provider Active NPI

Jessica Davis Burns

  • Pediatric Orthopaedic Surgery Physician
  • Phoenix, AZ
National Provider Identifier
1417375882
Registry record updated Dec 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Orthopaedic Surgery PhysicianTaxonomy code 207XP3100X
License
60971 Issued in AZ
Practice address
1919 E Thomas Rd FL 2
Phoenix, AZ 85016-7710
Phone
(602) 933-3033
Fax
(602) 933-5245
NPI assigned
Apr 2, 2014
Last updated
Dec 10, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X A159890 CA
Pediatric Orthopaedic Surgery Physician 207XP3100X 60971 AZ Primary

Addresses

Primary practice location

1919 E Thomas Rd FL 2
Phoenix, AZ 85016-7710

Mailing address

3200 E Camelback Rd Ste 250
Phoenix, AZ 85018-2327
Phone (602) 933-1814

Other practice location 1

3030 Childrens Way
San Diego, CA 92123-4232
Phone (858) 966-6789

Other names 1

  • Jessica Davis Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200513001456 AZ Practitioner - Orthopedic Surgery 0547529133 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A159890CAMDOrthopaedic Surgery Physician
60971AZMDPediatric Orthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenix Children's Medical Group CurrentSince Jun 1, 2020 Accepting new patients
Phoenix Children's Medical Group CurrentSince Jun 1, 2020 Accepting new patients
Phoenix Children's Hospital Current Accepting new patients
Phoenix Children's Hospital Past Accepting new patients

Locations

5131 E Southern Ave
Mesa, AZ 85206
Phone (480) 833-5437

1919 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 933-0777

1919 E Thomas Rd
Fl 2
Phoenix, AZ 85016
Phone (602) 933-3033

3200 E Camelback Rd
Ste 250
Phoenix, AZ 85018
Phone (602) 933-1814

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, 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": "1396396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607558400000",
    "number": "1417375882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 E CAMELBACK RD STE 250",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850182327",
            "telephone_number": "602-933-1814",
            "fax_number": "602-933-8972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 E THOMAS RD FL 2",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850167710",
            "telephone_number": "602-933-3033",
            "fax_number": "602-933-5245"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3030 Childrens Way",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921234232",
            "country_code": "US",
            "telephone_number": "858-966-6789",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURNS",
        "first_name": "JESSICA",
        "middle_name": "DAVIS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-02",
        "last_updated": "2020-12-10",
        "certification_date": "2020-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "A159890",
            "primary": false
        },
        {
            "code": "207XP3100X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Pediatric Orthopaedic Surgery",
            "state": "AZ",
            "license": "60971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "DAVIS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.