Active NPI
William Jon Burke, PT
- Physical Therapist
- Mount Vernon, OH
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 11052
- Practice address
- 812 Coshocton Ave
Mount Vernon, OH 43050-1947 - Phone
- (740) 392-8811
- NPI assigned
- Nov 13, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 11052 | OH | Primary |
Addresses
Primary practice location
812 Coshocton Ave
Mount Vernon, OH 43050-1947
Mailing address
11177 Lambs LN
Newark, OH 43055-9779
Phone (740) 763-0408
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2595053 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050721000173 | OH | Practitioner - Physical Therapist in Private Practice | 7911934906 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11052 | OH | MD | Physical Therapist |
| 011052 | OH | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rehabilitative Associates Inc | Physical Therapist | Current | Accepting new patients |
| Rehabilitative Associates Inc | Physical Therapist | Current | Accepting new patients |
| Licking Rehabilitation Services, Inc | Past | Accepting new patients | |
| Mohican Therapy Group | Physical Therapist | Past | Accepting new patients |
| Rehabilitative Associates Inc | Physical Therapist | Past | Accepting new patients |
| Licking Rehabilitation Services Inc | Physical Therapist | Past | Accepting new patients |
Locations
351 S Lane St
Ste 1
Bucyrus, OH 44820
Phone (419) 562-6686
1265 Lexington Ave
Mansfield, OH 44907
Phone (419) 525-4200
112 Harcourt Rd
Ste 1
Mount Vernon, OH 43050
Phone (740) 392-8811
11177 Lambs Ln
Newark, OH 43055
Phone (740) 763-0408
Organizations & group practices 6
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Occupational Therapist
- Pickerington, OH
- NPI 1770672099
OH, Physical Therapist
-
- Physical Therapist
- Mount Vernon, OH
- NPI 1215010434
-
- Physical Therapist
- Heath, OH
- NPI 1467549857
-
- Occupational Therapist
- Heath, OH
- NPI 1396104626
-
- Physical Therapist
- Marysville, OH
- NPI 1174795397
-
- Physical Therapist
- Bucyrus, OH
- NPI 1104909217
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Rehabilitative Associates Inc
Practice addresses (Care Compare)
112 Harcourt Rd
Suite 1
Mount Vernon, OH 43050-3944
Phone (740) 392-8811
1265 Lexington Ave
Mansfield, OH 44907-2613
Phone (419) 525-4200
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163376000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1210636800000",
"number": "1710058482",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11177 LAMBS LN",
"city": "NEWARK",
"state": "OH",
"postal_code": "430559779",
"telephone_number": "740-763-0408",
"fax_number": "740-763-0485"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "812 COSHOCTON AVE",
"city": "MOUNT VERNON",
"state": "OH",
"postal_code": "430501947",
"telephone_number": "740-392-8811"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURKE",
"first_name": "WILLIAM",
"middle_name": "JON",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-13",
"last_updated": "2008-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OH",
"license": "11052",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2595053",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Mount Vernon, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.