Individual provider Active NPI

Gabriel Winthrop Burks

  • Behavior Technician
  • Atlanta, GA
National Provider Identifier
1497513097
Registry record updated Mar 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
BACB1013647 Issued in GA
Practice address
6849 Peachtree Dunwoody Rd
Atlanta, GA 30328-1608
Phone
(678) 691-2206
NPI assigned
Mar 8, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X BACB1013647 GA Primary

Addresses

Primary practice location

6849 Peachtree Dunwoody Rd
Atlanta, GA 30328-1608

Mailing address

953 E Lake LNDG
Marietta, GA 30062-7513

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
BACB1013647GAMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1709856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709856000000",
    "number": "1497513097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "953 E LAKE LNDG",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300627513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6849 PEACHTREE DUNWOODY RD",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303281608",
            "telephone_number": "678-691-2206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURKS",
        "first_name": "GABRIEL",
        "middle_name": "WINTHROP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-03-08",
        "last_updated": "2024-03-08",
        "certification_date": "2024-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "GA",
            "license": "BACB1013647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2024; 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.