Individual provider Active NPI

Jonathan Mark Burg, MA, LMFT

  • Marriage & Family Therapist
  • Noblesville, IN
National Provider Identifier
1750678173
Registry record updated Apr 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
35001736A Issued in IN
Practice address
15214 Dry Creek Rd
Noblesville, IN 46060-4642
Phone
(317) 645-7691
NPI assigned
Jul 6, 2011
Last updated
Apr 15, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 35001736A IN Primary

Addresses

Primary practice location

15214 Dry Creek Rd
Noblesville, IN 46060-4642

Mailing address

15214 Dry Creek Rd
Noblesville, IN 46060-4642

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
35001736AINMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mosaic Counseling Services, LLC Marriage & Family Therapist Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1309910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460678400000",
    "number": "1750678173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15214 DRY CREEK RD",
            "city": "NOBLESVILLE",
            "state": "IN",
            "postal_code": "460604642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15214 DRY CREEK RD",
            "city": "NOBLESVILLE",
            "state": "IN",
            "postal_code": "460604642",
            "telephone_number": "317-645-7691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURG",
        "first_name": "JONATHAN",
        "middle_name": "MARK",
        "name_prefix": "Mr.",
        "credential": "MA, LMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-06",
        "last_updated": "2016-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IN",
            "license": "35001736A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Noblesville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2016; 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.