Individual provider Active NPI

Ryan Michael Burke, LPN

  • Licensed Practical Nurse
  • Novi, MI
National Provider Identifier
1720409709
Registry record updated Dec 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
4703109279 Issued in MI
Practice address
41521 W 11 Mile Rd
Novi, MI 48375-1803
Phone
(248) 299-0030
NPI assigned
Dec 18, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 4703109279 MI Primary

Addresses

Primary practice location

41521 W 11 Mile Rd
Novi, MI 48375-1803

Mailing address

8372 N Telegraph Rd Apt 4
Newport, MI 48166-9447
Phone (734) 682-2321

Other identifiers 1

IdentifierTypeStateIssuer
4703109279OtherMISTATE OF MICHIGAN DEPARTMENT OF LICENSING REGULATORY AFFAIRS BOARD OF NURSING

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

State licenses

LicenseStateTypeSpecialty
4703109279MIMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1387324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387324800000",
    "number": "1720409709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8372 N TELEGRAPH RD APT 4",
            "city": "NEWPORT",
            "state": "MI",
            "postal_code": "481669447",
            "telephone_number": "734-682-2321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41521 W 11 MILE RD",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483751803",
            "telephone_number": "248-299-0030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURKE",
        "first_name": "RYAN",
        "middle_name": "MICHAEL",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-12-18",
        "last_updated": "2013-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MI",
            "license": "4703109279",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF MICHIGAN DEPARTMENT OF LICENSING REGULATORY AFFAIRS BOARD OF NURSING",
            "identifier": "4703109279",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Novi, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2013; 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.