Individual provider Active NPI

Madeleine Carol Burgess, CFNP

  • Family Nurse Practitioner
  • Las Cruces, NM
National Provider Identifier
1609946342
Registry record updated Mar 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CNP-03017 Issued in NM
Practice address
1155 Commerce Dr
Suite G
Las Cruces, NM 88011-8257
Phone
(575) 647-5337
Fax
(575) 647-5338
NPI assigned
Nov 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2017

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 1106370 KY
Registered Nurse 163W00000X 16072 ID
Family Nurse Practitioner 363LF0000X 4594P KY
Family Nurse Practitioner 363LF0000X 16073A ID
Registered Nurse 163W00000X RN-84646 NM
Family Nurse Practitioner 363LF0000X CNP-03017 NM Primary

Addresses

Primary practice location

1155 Commerce Dr
Suite G
Las Cruces, NM 88011-8257

Mailing address

1009 Golf Course Rd SE Ste 109
Rio Rancho, NM 87124-4705
Phone (505) 891-3344

Other names 1

  • Lindi Carol Sather Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20230420003015 CO Practitioner - Nurse Practitioner 3870534639 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
16072IDMDRegistered Nurse
1106370KYMDRegistered Nurse
16073AIDMDFamily Nurse Practitioner
CNP-03017NMMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Intermountain Medical Group Grand Junction, LLC CurrentSince Mar 27, 2023 Accepting new patients
Intermountain Medical Group Grand Junction, LLC Current Accepting new patients
Intermountain Medical Group Grand Junction, LLC CurrentSince Mar 27, 2023 Accepting new patients

Locations

500 Eldorado Blvd
Ste 4300
Broomfield, CO 80021

1050 Wellington Ave
Grand Junction, CO 81501
Phone (970) 245-4810

1050 Wellington Ave
Slp Ctr
Grand Junction, CO 81501
Phone (970) 298-5864

Organizations & group practices 3

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": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490659200000",
    "number": "1609946342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1009 GOLF COURSE RD SE STE 109",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871244705",
            "telephone_number": "505-891-3344",
            "fax_number": "505-896-4499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1155 COMMERCE DR",
            "address_2": "SUITE G",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880118257",
            "telephone_number": "575-647-5337",
            "fax_number": "575-647-5338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURGESS",
        "first_name": "MADELEINE",
        "middle_name": "CAROL",
        "credential": "CFNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-09",
        "last_updated": "2017-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KY",
            "license": "1106370",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "ID",
            "license": "16072",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "4594P",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "16073A",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NM",
            "license": "RN-84646",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "CNP-03017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LINDI",
            "last_name": "SATHER",
            "middle_name": "CAROL",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Las Cruces, NM

Sources for this page

Verify at the official NPI Registry.