NPIMap

Individual provider Active NPI

Glenn A Burket III, DO

  • Emergency Medicine Physician
  • Grand Junction, CO
National Provider Identifier
1699185272
Registry record updated Jun 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
DR.0062036 Issued in CO
Practice address
2635 N 7TH St
Grand Junction, CO 81501-8209
Phone
(970) 298-2273
NPI assigned
May 5, 2014
Last updated
Jun 25, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 2019

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X DOS1989 HI
Emergency Medicine Physician 207P00000X OS017930 PA
Emergency Medicine Physician 207P00000X 2018-00485 NC
Emergency Medicine Physician 207P00000X OT015717 PA
Emergency Medicine Physician 207P00000X DR.0062036 CO Primary

Addresses

Primary practice location

2635 N 7TH St
Grand Junction, CO 81501-8209

Mailing address

2635 N 7TH St
Grand Junction, CO 81501-8209
Phone (970) 298-2273

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, HI2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190718000833 CO Practitioner - Emergency Medicine 6507080223 Reassigns benefits to 1 organization
I20200324002045 HI Practitioner - Emergency Medicine 6507080223 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Lake Erie College of Osteopathic Medicine, Erie, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Colorado West Emergency Physicians LLCGroup PAC ID 6103808035, 21 clinicians

Practice addresses (Care Compare)

2635 N 7TH St
Grand Junction, CO 81501-8209
Phone (970) 244-2273

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
DOS1989HIMDEmergency Medicine Physician
2018-00485NCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Colorado West Emergency Physicians, LLC Single Specialty CurrentSince Jul 1, 2019 Accepting new patients
Hawaii Emergency Physicians Associated Inc Single Specialty CurrentSince Mar 2, 2020 Accepting new patients
Midpacific Hospitalists LLC Single Specialty Past Accepting new patients
Regents of the University of California - Ucsd Medical Group Single Specialty Past Accepting new patients

Locations

Dept 0861
Denver, CO 80256
Phone (970) 298-1977

2635 N 7th St
Grand Junction, CO 81501
Phone (970) 244-2009

640 Ulukahiki St
Kailua, HI 96734
Phone (808) 261-3326

128 Lehua St
Wahiawa, HI 96786
Phone (808) 621-4330

Organizations & group practices 4

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1399248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561420800000",
    "number": "1699185272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2635 N 7TH ST",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815018209",
            "telephone_number": "970-298-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2635 N 7TH ST",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815018209",
            "telephone_number": "970-298-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURKET",
        "first_name": "GLENN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-05-05",
        "last_updated": "2019-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "HI",
            "license": "DOS1989",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "OS017930",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "2018-00485",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "OT015717",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CO",
            "license": "DR.0062036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Junction, CO

Sources for this page

Verify at the official NPI Registry.