Individual provider Active NPI

Jessen Mechell Burk, DO

  • Student in an Organized Health Care Education/Training Program
  • Rome, GA
National Provider Identifier
1669175402
Registry record updated Feb 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
501 Redmond Rd NW
Rome, GA 30165-1415
Phone
(706) 291-0291
NPI assigned
Mar 22, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

501 Redmond Rd NW
Rome, GA 30165-1415

Mailing address

1310 Burger Cir
Gadsden, AL 35903-1204
Phone (706) 767-8354

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230721001685 GA Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 7517327554

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Interoperability endpoints

  • Direct secure messaging: jburk1689658@adventhealth.direct-ci.com

NPI Registry JSON

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

{
    "created_epoch": "1679443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707523200000",
    "number": "1669175402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 BURGER CIR",
            "city": "GADSDEN",
            "state": "AL",
            "postal_code": "359031204",
            "telephone_number": "706-767-8354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 REDMOND RD NW",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301651415",
            "telephone_number": "706-291-0291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURK",
        "first_name": "JESSEN",
        "middle_name": "MECHELL",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-22",
        "last_updated": "2024-02-10",
        "certification_date": "2024-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rome, GA

Sources for this page

Verify at the official NPI Registry.