Active NPI
Debra Anne Burdick, WHCNP
- Nurse Practitioner
- Coon Rapids, MN
National Provider Identifier
1427014240
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- R 095751-9
- Practice address
- 3960 Coon Rapids Blvd NW
Coon Rapids, MN 55433-2569 - Phone
- (763) 236-9236
- NPI assigned
- Apr 21, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | R 095751-9 | MN | Primary |
Addresses
Primary practice location
3960 Coon Rapids Blvd NW
Coon Rapids, MN 55433-2569
Mailing address
2925 Chicago Ave
Minneapolis, MN 55407-1321
Phone (612) 262-4813
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 050042900 | Medicaid | MN |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | dburdick31354@excellian.direct.allina.com | Direct |
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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1369 | MN | MD | Acupuncturist |
| R 095751-9 | MN | MD | Nurse Practitioner |
Interoperability endpoints
- dburdick31354@excellian.direct.allina.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145577600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604966400000",
"number": "1427014240",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2925 CHICAGO AVE",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554071321",
"telephone_number": "612-262-4813",
"fax_number": "612-262-4194"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3960 COON RAPIDS BLVD NW",
"city": "COON RAPIDS",
"state": "MN",
"postal_code": "554332569",
"telephone_number": "763-236-9236"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURDICK",
"first_name": "DEBRA",
"middle_name": "ANNE",
"name_prefix": "Mrs.",
"credential": "WHCNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-04-21",
"last_updated": "2020-11-10",
"certification_date": "2020-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MN",
"license": "R 095751-9",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "050042900",
"state": "MN"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "dburdick31354@excellian.direct.allina.com",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CDA/PDF/TXT",
"address_1": "3960 Coon Rapids Blvd NW",
"city": "Coon Rapids",
"state": "MN",
"country_code": "US",
"postal_code": "554332569",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Coon Rapids, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.