Active NPI
Gary Burge Jr.
- Marriage & Family Therapist
- Tucson, AZ
National Provider Identifier
1609243021
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- LMFT-15572
- Practice address
- 260 S Scott Ave
Tucson, AZ 85701-1919 - Phone
- (520) 884-8470
- NPI assigned
- Sep 2, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | LMFT-15572 | AZ | Primary |
Addresses
Primary practice location
260 S Scott Ave
Tucson, AZ 85701-1919
Mailing address
504 W 29TH St
Tucson, AZ 85713-3353
Phone (520) 838-5600
Other practice location 1
320 N Eisenhower Ave
Mason City, IA 50401-1521
Phone (641) 424-2391
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
| License | State | Type | Specialty |
|---|---|---|---|
| LMFT-15572 | AZ | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lafrontera Center Inc | Current | Accepting new patients | |
| La Frontera Center, Inc. | Past | Accepting new patients |
Locations
260 S Scott Ave
Tucson, AZ 85701
Phone (520) 884-8470
504 W 29th St
Tucson, AZ 85713
Phone (520) 838-5600
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.
-
- Methadone Clinic
- Tucson, AZ
- NPI 1548361470
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Tucson, AZ
- NPI 1093810889
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1441152000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1615852800000",
"number": "1609243021",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "504 W 29TH ST",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857133353",
"telephone_number": "520-838-5600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "260 S SCOTT AVE",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857011919",
"telephone_number": "520-884-8470"
}
],
"practiceLocations": [
{
"address_1": "320 N Eisenhower Ave",
"address_purpose": "LOCATION",
"city": "Mason City",
"state": "IA",
"postal_code": "504011521",
"country_code": "US",
"telephone_number": "641-424-2391",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BURGE",
"first_name": "GARY",
"name_suffix": "Jr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-09-02",
"last_updated": "2021-03-16",
"certification_date": "2021-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "AZ",
"license": "LMFT-15572",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Tucson, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 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.