William K Burckhard, PA-C – Physician Assistant

Key facts

NPI: 1477592624
Entity type: Individual (NPI type 1)
Primary specialty: Physician Assistant 363A00000X
License: PAC0346 (ND)
Practice address: 3000 32ND Ave S
Fargo, ND 58103-6132
Phone: (701) 364-8000
Fax: (701) 364-8078
NPI assigned: Jun 5, 2006
Sex: Male
Sole proprietor: No

Organizations & group practices 9

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.

Theoria Medical Internal Medicine Physician · Novi, MI · NPI 1609362375

Medicare reassignment NPD MI · PHYSICIAN ASSISTANT
Adrian Urgent Care PLLC Family Medicine Physician · Adrian, MI · NPI 1003204769

Medicare reassignment MI
Complexcare Medical Group Midwest H PLLC Internal Medicine Physician · Novi, MI · NPI 1457144933

Medicare reassignment MI
Integrated Visiting Physician Solutions PC Multi-Specialty Clinic/Center · Southfield, MI · NPI 1891109641

Medicare reassignment MI
SNF Wound Care Internal Medicine Physician · Los Angeles, CA · NPI 1114393311

Medicare reassignment MI
Southgate Urgent Care PC Family Medicine Physician · Southgate, MI · NPI 1902904436

Medicare reassignment MI
Hans Bjellum MD PC Urgent Care Clinic/Center · Fargo, ND · NPI 1841547387

NPD (past)
Adrian Urgent Care PLLC Urgent Care Clinic/Center · Adrian, MI · NPI 1144611633

NPD (past)
Southgate Urgent Care PC Urgent Care Clinic/Center · Southgate, MI · NPI 1790967339

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Enrolled in MI
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
I20230203000120	MI	Practitioner - Physician Assistant	4981616240	Reassigns benefits to 6 organizations

National Provider Directory

Medicare enrollment (NPD): Yes
Credentials: Physician Assistant

State licenses

License	State	Type	Specialty
PAC0346	ND	MD	Physician Assistant

Practice roles

Organization	Specialty	Status	New patients
Theoria Medical	Physician Assistant	Current since Apr 7, 2025	Accepting new patients
Adrian Urgent Care PLLC		Past	Accepting new patients
Southgate Urgent Care PC		Past since Oct 22, 2023	Accepting new patients
Hans Bjellum MD PC		Past	Accepting new patients

Locations

5655 Clarkston Rd
Clarkston, MI 48348
Phone (810) 623-5216

6700 W Outer Dr
Detroit, MI 48235
Phone (313) 836-1700

3139 E Baldwin Rd
Grand Blanc, MI 48439
Phone (810) 445-5300

3003 W Grand River Ave
Howell, MI 48843
Phone (517) 323-9133

41800 W 11 Mile Rd
Ste 109
Novi, MI 48375
Phone (833) 578-2763

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Physician Assistant	363A00000X	PAC0346	ND	Yes

Addresses

Primary practice location

3000 32ND Ave S
Fargo, ND 58103-6132

Mailing address

PO Box 6001
Fargo, ND 58108-6001
Phone (701) 364-3300

Other providers in Fargo, ND

All providers in Fargo, ND · Physician Assistant in North Dakota

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 4, 2008. 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.

Verify at the official NPI Registry.