Mary Jo Burgoyne, RN, MSN, APNP

Primary specialty

Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0808X

License

510-033 Issued in WI

Practice address

9200 W Wisconsin Ave
Suite C-2130
Milwaukee, WI 53226-3522

Phone

(414) 805-9990

Fax

(414) 805-0970

NPI assigned

Jul 24, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Mary Jo Sims Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Registered Nurse

State licenses

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370476800000",
    "number": "1689696007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1522 N PROSPECT AVE",
            "address_2": "SUITE 1006",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532026512",
            "telephone_number": "414-916-4476",
            "fax_number": "414-805-0970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9200 W WISCONSIN AVE",
            "address_2": "SUITE C-2130",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263522",
            "telephone_number": "414-805-9990",
            "fax_number": "414-805-0970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURGOYNE",
        "first_name": "MARY JO",
        "credential": "RN, MSN, APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-24",
        "last_updated": "2013-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "66695-030",
            "primary": false
        },
        {
            "code": "364SP0808X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": "WI",
            "license": "510-033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40956800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY JO",
            "last_name": "SIMS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Riley Burgon, MD
• Elizabeth Burgos
• Lisa C Burgos
• Lourdes G Burgos, MD
• Vanessa I Burgos, MSN, APRN, CNM
• Kayla Burgun
• Lauren Burgunder, MD, MPH
• Meryn Burk, PA-C
• Heather R. Burkart, CAP
• Matthew Burkart

• Psychiatric/Mental Health Clinical Nurse Specialist in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Psychiatric/Mental Health Clinical Nurse Specialist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.