Nicole Bailey Burwell, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

54680 Issued in CA

Practice address

1215 Welch Rd # Modularf
Stanford, CA 94305-5102

Phone

(650) 724-0441

NPI assigned

May 16, 2006

Last updated

Mar 17, 2018By 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 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Stanford Health Care

  dba SHC Radiation Oncology

  • Radiation Oncology Physician
  • Pleasanton, CA
  • NPI 1124561758
  NPD
• Stanford Health Care

  dba Stanford Health Care Specialty Pharmacy

  • Specialty Pharmacy
  • Mountain View, CA
  • NPI 1760366132
  NPD
• Advanced Back and Neck Pain Center

  • Acupuncturist
  • Arlington, VA
  • NPI 1245302454
  NPD (past)
• Sikkema Chiropractic Virginia, Inc.

  • Clinic/Center
  • Arlington, VA
  • NPI 1093260309
  NPD (past)

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1568414969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 KIPLING ST",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943011527",
            "telephone_number": "504-408-2608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 WELCH RD # MODULARF",
            "city": "STANFORD",
            "state": "CA",
            "postal_code": "943055102",
            "telephone_number": "650-724-0441"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "46 S Glebe Rd",
            "address_2": "suite 100",
            "address_purpose": "LOCATION",
            "city": "Arlington",
            "state": "VA",
            "postal_code": "222041655",
            "country_code": "US",
            "telephone_number": "703-521-0644",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "46 S Glebe Rd",
            "address_2": "suite 100",
            "address_purpose": "LOCATION",
            "city": "Arlington",
            "state": "VA",
            "postal_code": "222041655",
            "country_code": "US",
            "telephone_number": "703-521-0644",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURWELL",
        "first_name": "NICOLE",
        "middle_name": "BAILEY",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-16",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "VA",
            "license": "0110840820",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "54680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patrick Barry Burns, MD
• Georgiana McDermott Burnside, MD
• Arun Bharadwaj Burra
• Elizabeth Meriwether Burrous, NP
• Eleanor Madison Burton, MD
• Erin Bushell, M.D.
• Stephan Busque, MD
• Philip Albert Buss
• Madelaine Claire Sibayan Bustos
• Samantha Butalid, FNP-BC, MSN, CNS, RN

• Physician Assistant in Stanford, CA
• Providers in Stanford, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.