Individual provider Active NPI

Debra Anne Burdick, WHCNP

  • Nurse Practitioner
  • Coon Rapids, MN
National Provider Identifier
1427014240
Registry record updated Nov 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R 095751-9 Issued in MN
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

Updated by the provider on Nov 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
050042900MedicaidMN

Electronic endpoints 1

TypeEndpointUseAffiliation
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

LicenseStateTypeSpecialty
1369MNMDAcupuncturist
R 095751-9MNMDNurse Practitioner

Interoperability endpoints

  • Direct secure messaging: 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.

Verify at the official NPI Registry.