Active NPI
Verna Jean Burnette, PAC
- Physician Assistant
- Jackson, KY
National Provider Identifier
1679677397
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA219
- Practice address
- 832 Hwy 15 N
Jackson, KY 41339-8601 - Phone
- (606) 666-5142
- Fax
- (606) 666-4172
- NPI assigned
- Sep 12, 2006
- Sex
- Female
- 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 | PA219 | KY | Primary |
Addresses
Primary practice location
832 Hwy 15 N
Jackson, KY 41339-8601
Mailing address
PO Box 907
Jackson, KY 41339-0907
Phone (606) 666-5142
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 183821 | Other | KY | RURAL HEALTH |
| 31000664 | Other | KY | MEDICAID GROUP |
| 6603 | Other | KY | MEDICARE GROUP |
| 95000923 | Medicaid | KY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 219 | KY | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Frederick Medical Clinic PSC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Rural Health Clinic/Center
- West Liberty, KY
- NPI 1194829812
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158019200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1244160000000",
"number": "1679677397",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 907",
"city": "JACKSON",
"state": "KY",
"postal_code": "413390907",
"telephone_number": "606-666-5142",
"fax_number": "606-666-4172"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "832 HWY 15 N",
"city": "JACKSON",
"state": "KY",
"postal_code": "413398601",
"telephone_number": "606-666-5142",
"fax_number": "606-666-4172"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURNETTE",
"first_name": "VERNA",
"middle_name": "JEAN",
"name_prefix": "Ms.",
"credential": "PAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-12",
"last_updated": "2009-06-05",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "KY",
"license": "PA219",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RURAL HEALTH",
"identifier": "183821",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID GROUP",
"identifier": "31000664",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE GROUP",
"identifier": "6603",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "95000923",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jackson, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.