NPIMap

Individual provider Active NPI

Jessica Lynn Burrows, PA

  • Medical Physician Assistant
  • Dothan, AL
National Provider Identifier
1710246731
Registry record updated Jun 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA.1506 Issued in AL
Practice address
1500 Ross Clark Cir
Dothan, AL 36301-4754
Phone
(334) 793-2663
Fax
(334) 836-2248
NPI assigned
May 11, 2012
Last updated
Jun 28, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA.1506 AL Primary
Medical Physician Assistant 363AM0700X PA9106559 FL

Addresses

Primary practice location

1500 Ross Clark Cir
Dothan, AL 36301-4754

Mailing address

PO Box 17308
Clearwater, FL 33762-0308
Phone (904) 482-1070

Other practice location 1

300 Pinellas St
Clearwater, FL 33756-3804
Phone (727) 298-6612

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, AL2 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
I20120517000201 FL Practitioner - Physician Assistant 5496918153 Reassigns benefits to 1 organization
I20190729003081 AL Practitioner - Physician Assistant 5496918153 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
S.B.J.S. PCGroup PAC ID 8527043421, 39 clinicians

Practice addresses (Care Compare)

1500 Ross Clark Cir
Dothan, AL 36301-4754
Phone (334) 793-2663

2126 W Roy Parker Rd
Suite 201
Ozark, AL 36360-8566
Phone (334) 445-2663

345 Healthwest Dr
Dothan, AL 36303-2053
Phone (334) 793-2663

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA.1506ALMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
S.B.J.S. PC CurrentSince Aug 1, 2019 Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients
S.B.J.S. PC Past Accepting new patients

Locations

1500 Ross Clark Cir
Dothan, AL 36301
Phone (334) 793-2663

345 Healthwest Dr
Dothan, AL 36303
Phone (334) 793-2663

2126 W Roy Parker Rd
Ste 201
Ozark, AL 36360
Phone (334) 445-2663

Interoperability endpoints

  • Direct secure messaging: jessica.burrows.1@15455.direct.athenahealth.com

Organizations & group practices 5

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 3

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": "1336694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561680000000",
    "number": "1710246731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 17308",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337620308",
            "telephone_number": "904-482-1070",
            "fax_number": "904-482-1077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 ROSS CLARK CIR",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363014754",
            "telephone_number": "334-793-2663",
            "fax_number": "334-836-2248"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Pinellas St",
            "address_purpose": "LOCATION",
            "city": "Clearwater",
            "state": "FL",
            "postal_code": "337563804",
            "country_code": "US",
            "telephone_number": "727-298-6612",
            "fax_number": "727-447-7175",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURROWS",
        "first_name": "JESSICA",
        "middle_name": "LYNN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-11",
        "last_updated": "2019-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AL",
            "license": "PA.1506",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9106559",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dothan, AL

Sources for this page

Verify at the official NPI Registry.