Active NPI
Phillip Neil Burk, D.P.M.
- Podiatrist
- Nampa, ID
National Provider Identifier
1699763540
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- P-99
- Practice address
- 203 12TH Ave Rd
Suite a
Nampa, ID 83686-5012 - Phone
- (208) 466-3338
- Fax
- (208) 466-3554
- NPI assigned
- Oct 13, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | P-99 | ID | Primary |
| Foot Surgery Podiatrist | 213ES0131X | P-99 | ID |
Addresses
Primary practice location
203 12TH Ave Rd
Suite a
Nampa, ID 83686-5012
Mailing address
2000 County Line Rd
Emmett, ID 83617-9721
Phone (208) 278-3031
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 480033019 | Other | ID | RAILROAD MEDICARE |
| P2446 | Other | ID | BLUE CROSS OF IDAHO |
| 000010015689 | Other | ID | REGENCE BLUE SHIELD |
| 001519600 | Medicaid | ID | |
| P2446 | Other | ID | BLUE CROSS |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129161600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1228435200000",
"number": "1699763540",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2000 COUNTY LINE RD",
"city": "EMMETT",
"state": "ID",
"postal_code": "836179721",
"telephone_number": "208-278-3031"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "203 12TH AVE RD",
"address_2": "SUITE A",
"city": "NAMPA",
"state": "ID",
"postal_code": "836865012",
"telephone_number": "208-466-3338",
"fax_number": "208-466-3554"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURK",
"first_name": "PHILLIP",
"middle_name": "NEIL",
"credential": "D.P.M.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-13",
"last_updated": "2008-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "ID",
"license": "P-99",
"primary": true
},
{
"code": "213ES0131X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot Surgery",
"state": "ID",
"license": "P-99",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "480033019",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS OF IDAHO",
"identifier": "P2446",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE BLUE SHIELD",
"identifier": "000010015689",
"state": "ID"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "001519600",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "P2446",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}Other providers in Nampa, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.