Clint Burgess, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

234960 Issued in AZ

Practice address

4463 E Des Moines St
Mesa, AZ 85205-6340

Phone

(480) 766-9828

NPI assigned

Jan 21, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Neurosin PLLC

  • Physical Medicine & Rehabilitation Physician
  • Chandler, AZ
  • NPI 1396378816
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1579564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696809600000",
    "number": "1447880299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4463 E DES MOINES ST",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852056340",
            "telephone_number": "480-766-9828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4463 E DES MOINES ST",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852056340",
            "telephone_number": "480-766-9828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURGESS",
        "first_name": "CLINT",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-21",
        "last_updated": "2023-10-09",
        "certification_date": "2023-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "TEMP234960",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "234960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sydney Buono, RBT
• Michelle Burak, CRNA
• Raquel Rae Burbank Roberts, MD
• Dylan Burger, DPT
• Kimberly Burger, LAC, PHD AC HMD
• Kathleen M Burgheimer, LCSW
• Gary Lynn Burk, D.C.
• Justin Burke
• James Burkett, PA-C
• Shelby Burlew, RN

• Family Nurse Practitioner in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2023; 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.