Individual provider Active NPI

Lezlie Williams Burden, PA-C

  • Physician Assistant
  • Dover, TN
National Provider Identifier
1649407750
Registry record updated Jun 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1640 Issued in TN
Practice address
1020 Moore Rd
Dover, TN 37058-3750
Phone
(931) 232-5141
Fax
(931) 232-3905
NPI assigned
Jun 16, 2009
Last updated
Jun 16, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1640 TN Primary

Addresses

Primary practice location

1020 Moore Rd
Dover, TN 37058-3750

Mailing address

1020 Moore Rd
Dover, TN 37058-3750
Phone (931) 232-5141

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20090918000431 TN Practitioner - Physician Assistant 7618023474 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1640TNMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
West Tennessee Healthcare Henry County CurrentSince Mar 11, 2018 Accepting new patients
Henry County Medical Center CurrentSince Mar 11, 2018 Accepting new patients
Clarksville Physician Services LLC Physician Assistant PastSince Apr 3, 2023 Accepting new patients

Locations

300 Hospital Cir
Ste 101
Paris, TN 38242

301 Tyson Ave
Paris, TN 38242
Phone (731) 642-1220

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/1879/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir-myrecord.cerner.com/r4/b673e6c7-c87b-498f-86b2-99b24c52c924/

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1245110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245110400000",
    "number": "1649407750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 MOORE RD",
            "city": "DOVER",
            "state": "TN",
            "postal_code": "370583750",
            "telephone_number": "931-232-5141",
            "fax_number": "931-232-3905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 MOORE RD",
            "city": "DOVER",
            "state": "TN",
            "postal_code": "370583750",
            "telephone_number": "931-232-5141",
            "fax_number": "931-232-3905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURDEN",
        "first_name": "LEZLIE",
        "middle_name": "WILLIAMS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-16",
        "last_updated": "2009-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "1640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dover, TN

Sources for this page

Verify at the official NPI Registry.