Maureen Burnham

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN222610 Issued in GA

Practice address

386 Highway 441 Byp
Baldwin, GA 30511-1807

Phone

(706) 407-0100

Fax

(770) 888-9998

NPI assigned

Mar 29, 2017

Last updated

Apr 27, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Northside Primary Care Professional Services,LLCGroup PAC ID 9638343924, 313 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Northside Primary Care Professional Services,LLC

  • Family Medicine Physician
  • Atlanta, GA
  • NPI 1922397553
  Medicare reassignment Care Compare group NPD
• Northside Primary Care Professional Services, LLC

  • Urgent Care Clinic/Center
  • Dawsonville, GA
  • NPI 1215369715
  NPD
• Internal Medicine Associates of Johns Creek

  • Internal Medicine Physician
  • Suwanee, GA
  • NPI 1992829717
  NPD (past)
• Thomas Karisny MD PC

  • Family Medicine Physician
  • Blairsville, GA
  • NPI 1134278187
  NPD (past)

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

{
    "created_epoch": "1490745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587945600000",
    "number": "1487186441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3850 WINDERMERE PKWY",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300417002",
            "telephone_number": "678-455-2800",
            "fax_number": "770-888-9998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "386 HIGHWAY 441 BYP",
            "city": "BALDWIN",
            "state": "GA",
            "postal_code": "305111807",
            "telephone_number": "706-407-0100",
            "fax_number": "770-888-9998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURNHAM",
        "first_name": "MAUREEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-29",
        "last_updated": "2020-04-27",
        "certification_date": "2020-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN222610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Garrick Keith Bailey, MD
• Baldwin Pharmacy LLC
• Baldwin Pharmacy LLC (Baldwin Pharmacy LLC LTC)
• Adelyn Grace Bolton
• Amy Beck Conner, CPNP-PC
• Thomas Jordan Crow, PHARMD
• Nicole Crumley, PA-C
• Christy A Floyd, R.N., CPNP-PC
• Georgia Mountains Community Services

• Family Nurse Practitioner in Baldwin, GA
• Providers in Baldwin, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.