Individual provider Active NPI

Stephon T Burks

  • Home Health Agency
  • Jamestown, NC
National Provider Identifier
1700637659
Registry record updated Jun 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Practice address
3904 Gisbourne Dr
Jamestown, NC 27282-7706
Phone
(919) 519-4081
NPI assigned
Mar 28, 2024
Last updated
Jun 25, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 2024

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Hand Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2251H1200X
Physical Therapy AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 225200000X
Community/Behavioral Health Agency 251S00000X
Home Health AideGroup: 193200000X MULTI-SPECIALTY GROUP 374U00000X
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

3904 Gisbourne Dr
Jamestown, NC 27282-7706

Mailing address

3904 Gisbourne Dr
Jamestown, NC 27282-7706
Phone (919) 519-4081

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)
Not enrolled

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1711584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719273600000",
    "number": "1700637659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3904 GISBOURNE DR",
            "city": "JAMESTOWN",
            "state": "NC",
            "postal_code": "272827706",
            "telephone_number": "919-519-4081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3904 GISBOURNE DR",
            "city": "JAMESTOWN",
            "state": "NC",
            "postal_code": "272827706",
            "telephone_number": "919-519-4081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURKS",
        "first_name": "STEPHON",
        "middle_name": "T",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-03-28",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251H1200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Hand",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapy Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamestown, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2024; 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.