Individual provider Active NPI

Penny Lynn Burcham, CFNP

  • Family Nurse Practitioner
  • Oxford, MS
National Provider Identifier
1609967520
Registry record updated Jun 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R859522 Issued in MS
Practice address
2908 S Lamar Blvd Ste 100
Oxford, MS 38655-5347
Phone
(662) 281-0112
Fax
(662) 281-0943
NPI assigned
Sep 27, 2006
Last updated
Jun 9, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R859522 MS Primary

Addresses

Primary practice location

2908 S Lamar Blvd Ste 100
Oxford, MS 38655-5347

Mailing address

2908 S Lamar Blvd Ste 100
Oxford, MS 38655-5347
Phone (662) 281-0112

Other identifiers 1

IdentifierTypeStateIssuer
07077714MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20050817000253 MS Practitioner - Nurse Practitioner 9537199781 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oxford Neuromuscular Associates, PLLCGroup PAC ID 5193766079, 5 clinicians

Practice addresses (Care Compare)

2908 S Lamar Blvd
Suite 100
Oxford, MS 38655-5375
Phone (662) 281-0112

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.86 of 100Reported as group
Quality
66.4
Promoting interoperability
100
Improvement activities
40
Cost
79.59

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R859522MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Oxford Neuromuscular Associates, PLLC CurrentSince Aug 1, 2012 Accepting new patients
Shiloh Neurology Past Accepting new patients
Mid-South Neurology-Sleep Medical Clinic PLLC PastSince Dec 1, 2011 Accepting new patients

Locations

2168 S Lamar Blvd
Oxford, MS 38655
Phone (662) 234-1448

2908 S Lamar Blvd
Ste 100
Oxford, MS 38655
Phone (662) 281-0112

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402272000000",
    "number": "1609967520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2908 S LAMAR BLVD STE 100",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386555347",
            "telephone_number": "662-281-0112",
            "fax_number": "662-281-0943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2908 S LAMAR BLVD STE 100",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386555347",
            "telephone_number": "662-281-0112",
            "fax_number": "662-281-0943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURCHAM",
        "first_name": "PENNY",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "CFNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-27",
        "last_updated": "2014-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R859522",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07077714",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oxford, MS

Sources for this page

Verify at the official NPI Registry.