Individual provider Active NPI

Karrie A Burkhardt, P.A.-C

  • Physician Assistant
  • Lebanon, TN
National Provider Identifier
1437422342
Registry record updated Dec 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
3462 Issued in TN
Practice address
107 Glidepath Way
Lebanon, TN 37090-4133
Phone
(615) 449-5771
Fax
(615) 449-5740
NPI assigned
Feb 23, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 3462 TN Primary

Addresses

Primary practice location

107 Glidepath Way
Lebanon, TN 37090-4133

Mailing address

107 Glidepath Way
Lebanon, TN 37090-4133
Phone (615) 449-5771

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180723003517 TN Practitioner - Physician Assistant 4385881366 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Oklahoma College of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cumberland Skin Surgery and DermatologyGroup PAC ID 0941391338, 55 clinicians

Practice addresses (Care Compare)

107 Glidepath Way
Lebanon, TN 37090-4133
Phone (615) 449-5771

3786 Central Pike
Suite 110
Hermitage, TN 37076-3498
Phone (615) 964-5941

Merit-based Incentive Payment System (MIPS)

Final score
87.25 of 100Reported as group
Promoting interoperability
85
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
3462TNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Vascular Associates LLC Past Accepting new patients
Advanced Sleep Consultants of Middle TN, Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: kburkhardt@directaddress.net

Organizations & group practices 3

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": "1329955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703808000000",
    "number": "1437422342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 GLIDEPATH WAY",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "370904133",
            "telephone_number": "615-449-5771",
            "fax_number": "615-449-5740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 GLIDEPATH WAY",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "370904133",
            "telephone_number": "615-449-5771",
            "fax_number": "615-449-5740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURKHARDT",
        "first_name": "KARRIE",
        "middle_name": "A",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-23",
        "last_updated": "2023-12-29",
        "certification_date": "2023-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "3462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, TN

Sources for this page

Verify at the official NPI Registry.