NPIMap

Individual provider Active NPI

Nicholas Tate Burris

  • Student in an Organized Health Care Education/Training Program
  • Madisonville, KY
National Provider Identifier
1417651969
Registry record updated Mar 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
900 Hospital Dr
Madisonville, KY 42431-1644
Phone
(270) 825-5100
NPI assigned
Mar 29, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

900 Hospital Dr
Madisonville, KY 42431-1644

Mailing address

380 Country Club LN Apt F
Madisonville, KY 42431-3836
Phone (270) 619-1609

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Louisville School of Medicine, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baptist Health Deaconess Medical Group IncGroup PAC ID 6103220330, 241 clinicians

Practice addresses (Care Compare)

900 Hospital Dr
Madisonville, KY 42431-1644
Phone (270) 825-5101

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Organizations & group practices 10

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": "1680048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680048000000",
    "number": "1417651969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "380 COUNTRY CLUB LN APT F",
            "city": "MADISONVILLE",
            "state": "KY",
            "postal_code": "424313836",
            "telephone_number": "270-619-1609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 HOSPITAL DR",
            "city": "MADISONVILLE",
            "state": "KY",
            "postal_code": "424311644",
            "telephone_number": "270-825-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURRIS",
        "first_name": "NICHOLAS",
        "middle_name": "TATE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-29",
        "last_updated": "2023-03-29",
        "certification_date": "2023-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madisonville, KY

Sources for this page

Verify at the official NPI Registry.