Individual provider Active NPI

Carolyn Ruth Burkhardt, MD

  • Specialist
  • Greenwood Village, CO
National Provider Identifier
1457398075
Registry record updated Sep 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
28021 Issued in CO
Practice address
5200 DTC Pkwy
#280
Greenwood Village, CO 80111-2709
Phone
(720) 200-5454
Fax
(720) 200-5460
NPI assigned
Jun 1, 2006
Last updated
Sep 8, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 28021 CO Primary

Addresses

Primary practice location

5200 DTC Pkwy
#280
Greenwood Village, CO 80111-2709

Mailing address

5200 DTC Pkwy
#280
Greenwood Village, CO 80111-2709
Phone (720) 200-5454

Other identifiers 1

IdentifierTypeStateIssuer
C808014OtherMEDICARE ID

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
28021COMDSpecialist

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315440000000",
    "number": "1457398075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 DTC PKWY",
            "address_2": "#280",
            "city": "GREENWOOD VILLAGE",
            "state": "CO",
            "postal_code": "801112709",
            "telephone_number": "720-200-5454",
            "fax_number": "720-200-5460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5200 DTC PKWY",
            "address_2": "#280",
            "city": "GREENWOOD VILLAGE",
            "state": "CO",
            "postal_code": "801112709",
            "telephone_number": "720-200-5454",
            "fax_number": "720-200-5460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURKHARDT",
        "first_name": "CAROLYN",
        "middle_name": "RUTH",
        "name_prefix": "Ms.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-01",
        "last_updated": "2011-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CO",
            "license": "28021",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "C808014",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwood Village, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2011; 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.