Active NPI
William K Burckhard, PA-C
- Physician Assistant
- Fargo, ND
National Provider Identifier
1477592624
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PAC0346
- Practice address
- 3000 32ND Ave S
Fargo, ND 58103-6132 - Phone
- (701) 364-8000
- Fax
- (701) 364-8078
- NPI assigned
- Jun 5, 2006
- Last updated
- Nov 4, 2008
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PAC0346 | ND | Primary |
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
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- 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 | Accepting new patients |
| Adrian Urgent Care PLLC | Past | Accepting new patients | |
| Wellbridge of Clarkston, LLC | Past | Accepting new patients | |
| Southgate Urgent Care PC | Past | 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
Organizations & group practices 10
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.
-
- Family Medicine Physician
- Adrian, MI
- NPI 1003204769
-
- Internal Medicine Physician
- Novi, MI
- NPI 1457144933
-
- Multi-Specialty Clinic/Center
- Southfield, MI
- NPI 1891109641
-
- Family Medicine Physician
- Southgate, MI
- NPI 1902904436
-
- Urgent Care Clinic/Center
- Adrian, MI
- NPI 1144611633
-
- Urgent Care Clinic/Center
- Southgate, MI
- NPI 1790967339
-
- Skilled Nursing Facility
- Independence Township, MI
- NPI 1669965299
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149465600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1225756800000",
"number": "1477592624",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 6001",
"city": "FARGO",
"state": "ND",
"postal_code": "581086001",
"telephone_number": "701-364-3300",
"fax_number": "701-364-8906"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3000 32ND AVE S",
"city": "FARGO",
"state": "ND",
"postal_code": "581036132",
"telephone_number": "701-364-8000",
"fax_number": "701-364-8078"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURCKHARD",
"first_name": "WILLIAM",
"middle_name": "K",
"name_prefix": "Mr.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-05",
"last_updated": "2008-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "ND",
"license": "PAC0346",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fargo, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.