Individual provider Active NPI

Gary Burge Jr.

  • Marriage & Family Therapist
  • Tucson, AZ
National Provider Identifier
1609243021
Registry record updated Mar 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT-15572 Issued in AZ
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

Updated by the provider on Mar 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
LMFT-15572AZMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Lafrontera Center Inc CurrentSince Jul 21, 2024 Accepting new patients
La Frontera Center, Inc. PastSince Mar 21, 2021 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.

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.

Verify at the official NPI Registry.