Jennifer Burner, PA-C
Individual provider Active NPI Medical Physician Assistant · Philippi, WV
NPI 1477540268 · NPPES record last updated Jun 13, 2024
Key facts
- NPI
- 1477540268
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Medical Physician Assistant 363AM0700X
- License
- WV00648 (WV)
- Practice address
- 109 Wabash Ave
Philippi, WV 26416-0019 - Phone
- (304) 457-1670
- Fax
- (304) 457-1296
- NPI assigned
- Oct 5, 2005
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WV
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050705000198 | WV | Practitioner - Physician Assistant | 7012953706 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 648 | WV | MD | Health Educator |
| WV00648 | WV | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Signify Health Medical Associates, PLLC | Current |
Accepting new patients | |
| United Hospital Center, Inc. | Past | Accepting new patients |
Locations
4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | WV00648 | WV | Yes |
Addresses
Primary practice location
109 Wabash Ave
Philippi, WV 26416-0019
Mailing address
109 Wabash Ave
Philippi, WV 26416-0019
Phone (304) 457-1670
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477540268 | Medicaid | WV | |
| P00276763 | Other | WV | RAILROAD MEDICARE |
| WV1327C | Other | WV | MEDICARE PTAN |
| 3810000531 | Medicaid | WV |
Other providers in Philippi, WV
- Broaddus Hospital Association, Inc.
- Broaddus Hospital Association, Inc.
- Broaddus Hospital Association, Inc.
- Broaddus Hospital Group
- Megan Bubnar
- Wilma Leigh Burr
- Garrett L Butler
- Michael Scott Butler
- Dianne Adrian Byrer
- Rachel Carr
All providers in Philippi, WV · Medical Physician Assistant in West Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 13, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.