Macy Alexandra Burk, COTA/L

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

057.005435 Issued in IL

Practice address

1104 Olde Lantern LN
Belleville, IL 62223-3267

Phone

(618) 477-4827

NPI assigned

May 11, 2021

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1620691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620691200000",
    "number": "1487238754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1104 OLDE LANTERN LN",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622233267",
            "telephone_number": "618-477-4827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1104 OLDE LANTERN LN",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622233267",
            "telephone_number": "618-477-4827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURK",
        "first_name": "MACY",
        "middle_name": "ALEXANDRA",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-11",
        "last_updated": "2021-05-11",
        "certification_date": "2021-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "IL",
            "license": "057.005435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Buehne, OTR/L
• Jacqueline Elaine Bullard, OD
• Kayla Jean Bumpus, PT, DPT
• Stephen K. Burger, M. D.
• Patricia Burhanna, ANP, RN
• Michelle M Burk, DO
• Robert Christopher Burke, MD
• Tevin Burks, PT,DPT
• Angela Catherine Burns, MSN, FNP-C
• Grace Burns, LPMT, MT-BC

• Occupational Therapy Assistant in Belleville, IL
• Providers in Belleville, IL by specialty
• Occupational Therapy Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.