Individual provider Active NPI

Bruce L Burnett, A.R.N.P.C.

  • Nurse Practitioner
  • West Des Moines, IA
National Provider Identifier
1699773945
Registry record updated Jun 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
A054714 Issued in IA
Practice address
5950 University Ave
Ste 105
West Des Moines, IA 50266
Phone
(515) 875-9070
Fax
(515) 875-9071
NPI assigned
Jul 11, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X A054714 IA Primary

Addresses

Primary practice location

5950 University Ave
Ste 105
West Des Moines, IA 50266

Mailing address

7147 Vista Dr Ste 150
West Des Moines, IA 50266-9313
Phone (515) 875-9925

Other identifiers 2

IdentifierTypeStateIssuer
0685214MedicaidIA
47420OtherIABLUE SHIELD OF IA

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
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
A054714IAMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1121040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529539200000",
    "number": "1699773945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7147 VISTA DR STE 150",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502669313",
            "telephone_number": "515-875-9925",
            "fax_number": "515-875-9923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5950 UNIVERSITY AVE",
            "address_2": "STE 105",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "50266",
            "telephone_number": "515-875-9070",
            "fax_number": "515-875-9071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURNETT",
        "first_name": "BRUCE",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "A.R.N.P.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-11",
        "last_updated": "2018-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IA",
            "license": "A054714",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0685214",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF IA",
            "identifier": "47420",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Des Moines, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2018; 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.