Individual provider Active NPI

John Michael Burr, LCSW

  • Clinical Social Worker
  • Orem, UT
National Provider Identifier
1689797078
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
135605-3501 Issued in UT
Practice address
889 S Orem Blvd
Orem, UT 84058-5009
Phone
(801) 225-7805
Fax
(801) 225-4946
NPI assigned
Apr 9, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 135605-3501 UT Primary

Addresses

Primary practice location

889 S Orem Blvd
Orem, UT 84058-5009

Mailing address

889 South Orem Blvd.
Orem, UT 84058-5009
Phone (801) 225-7805

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Apr 16, 2024 through Apr 16, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
135605-3501UTMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1176076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689797078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "889 SOUTH OREM BLVD.",
            "city": "OREM",
            "state": "UT",
            "postal_code": "840585009",
            "telephone_number": "801-225-7805",
            "fax_number": "801-225-4946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "889 S OREM BLVD",
            "city": "OREM",
            "state": "UT",
            "postal_code": "840585009",
            "telephone_number": "801-225-7805",
            "fax_number": "801-225-4946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURR",
        "first_name": "JOHN",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "135605-3501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orem, UT

Sources for this page

Verify at the official NPI Registry.