Active NPI
Daniel Burleson, PA-C
- Physician Assistant
- Sanford, NC
National Provider Identifier
1679045835
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 0010-08684
- Practice address
- 1212 Central Dr Ste 103
Sanford, NC 27330-4170 - Phone
- (919) 935-0773
- NPI assigned
- Dec 27, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 0010-08684 | NC | Primary |
Addresses
Primary practice location
1212 Central Dr Ste 103
Sanford, NC 27330-4170
Mailing address
2911 Breezewood Ave Ste 100
Fayetteville, NC 28303-5464
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20201119002151 | NC | Order and Referring Only - Physician Assistant | 6002156247 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0010-08684 | NC | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1545868800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1545868800000",
"number": "1679045835",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2911 BREEZEWOOD AVE STE 100",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283035464"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1212 CENTRAL DR STE 103",
"city": "SANFORD",
"state": "NC",
"postal_code": "273304170",
"telephone_number": "919-935-0773"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURLESON",
"first_name": "DANIEL",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-12-27",
"last_updated": "2018-12-27",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NC",
"license": "0010-08684",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sanford, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.