Individual provider Active NPI

Jordin Alena Burleson, ATC, DPT

  • Physical Therapist
  • Wichita, KS
National Provider Identifier
1609559673
Registry record updated Aug 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
11120 E 26TH St N
Wichita, KS 67226-4548
Phone
(316) 858-1177
NPI assigned
Aug 8, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary

Addresses

Primary practice location

11120 E 26TH St N
Wichita, KS 67226-4548

Mailing address

9812 W Shade LN
Wichita, KS 67212-3941
Phone (316) 992-6681

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230907002679 KS Practitioner - Physical Therapist in Private Practice 4284098385 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physical Therapy Services at Cypress LLCGroup PAC ID 5294702122, 6 clinicians
Phoenix Physical Therapy LLCGroup PAC ID 3779914544, 50 clinicians

Practice addresses (Care Compare)

11120 E 26TH St N
1300 Core Physical Therapy LLC
Wichita, KS 67226-4603
Phone (316) 858-1177

3223 N Webb Rd
Suite 2
Wichita, KS 67226-8176
Phone (316) 260-3311

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Physical Therapy Services at Cypress LLC Physical Therapist CurrentSince Jul 31, 2023 Accepting new patients

Locations

11120 E 26th St N
Ste 1300
Wichita, KS 67226
Phone (316) 858-1177

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": "1691452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691452800000",
    "number": "1609559673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9812 W SHADE LN",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672123941",
            "telephone_number": "316-992-6681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11120 E 26TH ST N",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672264548",
            "telephone_number": "316-858-1177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURLESON",
        "first_name": "JORDIN",
        "middle_name": "ALENA",
        "credential": "ATC, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-08",
        "last_updated": "2023-08-08",
        "certification_date": "2023-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.