Individual provider Active NPI

Gail Burke, DO, MA

  • Family Medicine Physician
  • Jackson, MI
National Provider Identifier
1710983309
Registry record updated Sep 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101014951 Issued in MI
Practice address
2200 Springport Rd
Jackson, MI 49202-1432
Phone
(517) 784-9356
Fax
(517) 780-9286
NPI assigned
Jun 28, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5101014951 MI Primary

Addresses

Primary practice location

2200 Springport Rd
Jackson, MI 49202-1432

Mailing address

2298 Springport Rd
Ste B
Jackson, MI 49202-1475
Phone (517) 784-3950

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180808000264 LA Practitioner - Family Practice 1557324977 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Louisiana State University School of Medicine in New Orleans Faculty G CurrentSince Jul 1, 2018 Accepting new patients
Louisiana State University School of Medicine in New Orleans Faculty G CurrentSince Jul 1, 2018 Accepting new patients

Locations

2025 Gravier St
Fl 6
New Orleans, LA 70112

1542 Tulane Ave
New Orleans, LA 70112
Phone (504) 866-2741

2832 Burdette St
New Orleans, LA 70125
Phone (504) 866-2741

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1119916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254182400000",
    "number": "1710983309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2298 SPRINGPORT RD",
            "address_2": "STE B",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492021475",
            "telephone_number": "517-784-3950",
            "fax_number": "517-817-1681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 SPRINGPORT RD",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492021432",
            "telephone_number": "517-784-9356",
            "fax_number": "517-780-9286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURKE",
        "first_name": "GAIL",
        "name_prefix": "Dr.",
        "credential": "DO, MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-28",
        "last_updated": "2009-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101014951",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

Verify at the official NPI Registry.