Active NPI
Mary Jean Burke, PT
- Geriatric Physical Therapist
- Indianapolis, IN
National Provider Identifier
1467460196
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Physical Therapist
- License
- 05002324A
- Practice address
- 6046 Sandcherry Dr
Indianapolis, IN 46236-6334 - Phone
- (317) 826-4263
- NPI assigned
- Aug 5, 2006
- Last updated
- Jul 8, 2007
- 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 |
|---|---|---|---|---|
| Geriatric Physical Therapist | 2251G0304X | 05002324A | IN | Primary |
Addresses
Primary practice location
6046 Sandcherry Dr
Indianapolis, IN 46236-6334
Mailing address
1481 West 10TH Street
C/O Richard Roudebush Vamc
Indianapolis, IN 46202
Phone (317) 988-2751
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 05002324A | IN | MD | Geriatric Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154736000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1467460196",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1481 WEST 10TH STREET",
"address_2": "C/O RICHARD ROUDEBUSH VAMC",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "46202",
"telephone_number": "317-988-2751",
"fax_number": "317-988-3312"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6046 SANDCHERRY DR",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462366334",
"telephone_number": "317-826-4263"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURKE",
"first_name": "MARY JEAN",
"name_prefix": "Miss",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2251G0304X",
"taxonomy_group": "",
"desc": "Physical Therapist, Geriatrics",
"state": "IN",
"license": "05002324A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.