Charity Joy Burkhardt, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

3065 W Southlake Blvd # 140
Southlake, TX 76092-6730

Phone

(817) 380-5911

Fax

(817) 385-6579

NPI assigned

May 21, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Charity Joy Buchanan Former name

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Physician Assistant

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Forefront Dermatology SCGroup PAC ID 3779471701, 650 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: charity.burkhardt@forefrontdermatology.emadirect.md

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.

• Forefront Dermatology, S.C.

  dba North Dallas Dermatology Associates, A Forefront Dermatology Practice

  • Dermatology Physician
  • Dallas, TX
  • NPI 1639808652
  Medicare reassignment Care Compare group NPD
• On Site Dermatology of Texas PLLC

  • Dermatology Physician
  • Cedar Park, TX
  • NPI 1568808459
  Medicare reassignment
• Forefront Dermatology, S.C.

  dba Compassion Dermatology, A Forefront Dermatology Practice

  • Dermatology Physician
  • Southlake, TX
  • NPI 1073298832
  NPD
• Forefront Dermatology, S.C.

  • Dermatology Physician
  • Columbus, OH
  • NPI 1063365385
  NPD
• Forefront Dermatology, S.C.

  • Dermatology Physician
  • Manitowoc, WI
  • NPI 1578515904
  NPD (past)

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

{
    "created_epoch": "1369094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724889600000",
    "number": "1689010340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 YORK ST",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542204630",
            "telephone_number": "920-663-9008",
            "fax_number": "920-684-1439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3065 W SOUTHLAKE BLVD # 140",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926730",
            "telephone_number": "817-380-5911",
            "fax_number": "817-385-6579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURKHARDT",
        "first_name": "CHARITY",
        "middle_name": "JOY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-21",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DPS CERTIFICATE NUMBER",
            "identifier": "S0201078",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "PA08610",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHARITY",
            "last_name": "BUCHANAN",
            "middle_name": "JOY",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Built 4 It Athletics (Built 4 It Southlake)
• Bull Care, PLLC
• Joanna Bullock, MSPT
• Mia Chikita Burgan, MA, LPC
• Tara L Burkett
• Melanie Ann Burman, LCSW
• Mariah Fiorillo Burnell, D.O.
• Catherine Word Burton, M.A., LPC, LMFT
• Stacie Lynn Bussey, RNFA
• Madison Buth

• Physician Assistant in Southlake, TX
• Providers in Southlake, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.