Individual provider Active NPI

Brian Ruschman Burkhardt, ARNP

  • Nurse Practitioner
  • Edgewood, KY
National Provider Identifier
1730115569
Registry record updated Nov 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
3004382 Issued in KY
Practice address
711 Medical Village Dr
Edgewood, KY 41017
Phone
(859) 301-9010
Fax
(859) 301-9018
NPI assigned
Jun 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 3004382 KY
Nurse Practitioner 363L00000X 3004382 KY Primary

Addresses

Primary practice location

711 Medical Village Dr
Edgewood, KY 41017

Mailing address

PO Box 636324
Cincinnati, OH 45263-6324
Phone (859) 301-9010

Other identifiers 2

IdentifierTypeStateIssuer
78013000MedicaidKY
3037672MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041019000914 KY Practitioner - Nurse Practitioner 2365403805 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

Practice roles

OrganizationSpecialtyStatusNew patients
St. Elizabeth Medical Center, Inc. Nurse Practitioner CurrentSince Mar 14, 2009 Accepting new patients
St Elizabeth Medical Center, Inc Nurse Practitioner Current Accepting new patients
St Elizabeth Medical Center, Inc CurrentSince Mar 14, 2009 Accepting new patients
Cumberland Orthopaedics and Sports Medicine, PLLC Nurse Practitioner Past Accepting new patients

Locations

711 Medical Village Dr
Edgewood, KY 41017
Phone (859) 287-3045

20 Medical Village Dr
Edgewood, KY 41017
Phone (859) 344-1600

1 Medical Village Dr
Edgewood, KY 41017
Phone (859) 301-2000

20 Medical Village Dr
Ste 204
Edgewood, KY 41017
Phone (859) 301-5959

238 Barnes Rd
Williamstown, KY 41097
Phone (859) 292-4000

Interoperability endpoints

  • Direct secure messaging: bburkhardt18269@direct-prd.stelizabeth.com

Organizations & group practices 4

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": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635984000000",
    "number": "1730115569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 636324",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452636324",
            "telephone_number": "859-301-9010",
            "fax_number": "859-301-9018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 MEDICAL VILLAGE DR",
            "city": "EDGEWOOD",
            "state": "KY",
            "postal_code": "41017",
            "telephone_number": "859-301-9010",
            "fax_number": "859-301-9018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURKHARDT",
        "first_name": "BRIAN",
        "middle_name": "RUSCHMAN",
        "name_prefix": "Mr.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2021-11-04",
        "certification_date": "2021-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "KY",
            "license": "3004382",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3004382",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "78013000",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3037672",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edgewood, KY

Sources for this page

Verify at the official NPI Registry.