Individual provider Active NPI

Timothy Burks

  • Mental Health Counselor
  • Jonesboro, AR
National Provider Identifier
1497200596
Registry record updated Sep 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
2200 E Matthews Ave
Jonesboro, AR 72401-4347
Phone
(870) 972-1268
NPI assigned
Aug 18, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary
Case Manager/Care Coordinator 171M00000X

Addresses

Primary practice location

2200 E Matthews Ave
Jonesboro, AR 72401-4347

Mailing address

2809 Forest Home Rd
Jonesboro, AR 72401-5320
Phone (866) 972-1268

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250814002901 AR Practitioner - Mental Health Counselor 9638678923 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4299 Savanah Hills Dr
Apt 253
Jonesboro, AR 72404-7066

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Secure Foundation Counseling PLLC CurrentSince Jul 15, 2025 Accepting new patients
Camden Medical Supply Inc PastSince Jul 15, 2025 Accepting new patients

Locations

818 E Matthews Ave
Jonesboro, AR 72401
Phone (870) 218-1722

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1471478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600214400000",
    "number": "1497200596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2809 FOREST HOME RD",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724015320",
            "telephone_number": "866-972-1268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 E MATTHEWS AVE",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724014347",
            "telephone_number": "870-972-1268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURKS",
        "first_name": "TIMOTHY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-18",
        "last_updated": "2020-09-16",
        "certification_date": "2020-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, AR

Sources for this page

Verify at the official NPI Registry.