Active NPI
Bret O Burquest MD PA
- Psychiatry Physician
- Charlette, NC
National Provider Identifier
1609986785
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 29082
- Legal business name
- BRET O BURQUEST MD PA
- Practice address
- 1515 Mockingbird Lane
Suite 530
Charlette, NC 28209 - Phone
- (704) 541-0800
- NPI assigned
- Aug 30, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Bret Burquest
- Title
- President
- Phone
- (704) 541-0800
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 29082 | NC | Primary |
Addresses
Primary practice location
1515 Mockingbird Lane
Suite 530
Charlette, NC 28209
Mailing address
1515 Mockingbird Lane
Suite 530
Charlette, NC 28209
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8919926 | Medicaid | NC |
National Provider Directory
National Provider DirectoryLocations
1515 Mockingbird Ln
Ste 530
Charlotte, NC 28209
Phone (704) 541-0800
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1609986785",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1515 MOCKINGBIRD LANE",
"address_2": "SUITE 530",
"city": "CHARLETTE",
"state": "NC",
"postal_code": "28209"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1515 MOCKINGBIRD LANE",
"address_2": "SUITE 530",
"city": "CHARLETTE",
"state": "NC",
"postal_code": "28209",
"telephone_number": "704-541-0800"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BRET O BURQUEST MD PA",
"organizational_subpart": "NO",
"enumeration_date": "2006-08-30",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "BURQUEST",
"authorized_official_first_name": "BRET",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "704-541-0800"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NC",
"license": "29082",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8919926",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.