Individual provider Active NPI

Alyson Burkhardt, FNP-C

  • Nurse Practitioner
  • Panama City, FL
National Provider Identifier
1508234865
Registry record updated Sep 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
9417888 Issued in FL
Practice address
615 N Bonita Ave
Panama City, FL 32401-3623
Phone
(850) 747-6265
NPI assigned
Sep 3, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Registered Nurse 163WE0003X 1-110471 AL
Nurse Practitioner 363L00000X 9417888 FL Primary

Addresses

Primary practice location

615 N Bonita Ave
Panama City, FL 32401-3623

Mailing address

615 N Bonita Ave
Panama City, FL 32401-3623

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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

Enrollment IDStateProvider typePAC IDDetails
I20210809002254 AL Practitioner - Nurse Practitioner 6608177050 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Houston County Healthcare AuthorityGroup PAC ID 9436062296, 256 clinicians

Practice addresses (Care Compare)

1108 Ross Clark Cir
Dothan, AL 36301-3022
Phone (334) 793-8087

Hospital & facility affiliations

  • Southeast Health Medical Center Hospital, Dothan, AL, CCN 010001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1-110471ALMDEmergency Registered Nurse
9417888FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Houston County Healthcare Authority Nurse Practitioner CurrentSince Jun 10, 2021 Accepting new patients
Medcore Associates, PLLC Current Accepting new patients
Houston County Healthcare Authority Current Accepting new patients
Pathology Laboratory Associates Current Accepting new patients
Houston County Healthcare Authority Current Accepting new patients

Locations

1108 Ross Clark Cir
Dothan, AL 36301
Phone (334) 712-3635

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1441238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442880000000",
    "number": "1508234865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 N BONITA AVE",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324013623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 N BONITA AVE",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324013623",
            "telephone_number": "850-747-6265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURKHARDT",
        "first_name": "ALYSON",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-03",
        "last_updated": "2015-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "AL",
            "license": "1-110471",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "9417888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Panama City, FL

Sources for this page

Verify at the official NPI Registry.