Individual provider Active NPI

Patricia Burkert

  • Clinical Social Worker
  • Chapel Hill, NC
National Provider Identifier
1750746012
Registry record updated Oct 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C012481 Issued in NC
Practice address
104 New Stateside Dr
Chapel Hill, NC 27516
Phone
(919) 967-8844
NPI assigned
Dec 30, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X C012481 NC Primary

Addresses

Primary practice location

104 New Stateside Dr
Chapel Hill, NC 27516

Mailing address

104 New Stateside Dr
Chapel Hill, NC 27516-1165
Phone (919) 967-8844

Other practice location 1

104 New Stateside Dr
Chapel Hill, NC 27516
Phone (919) 967-8844 ext. 225

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
C012481NCMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1451433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570147200000",
    "number": "1750746012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 NEW STATESIDE DR",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275161165",
            "telephone_number": "919-967-8844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 NEW STATESIDE DR",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "27516",
            "telephone_number": "919-967-8844"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "104 New Stateside Dr",
            "address_purpose": "LOCATION",
            "city": "Chapel Hill",
            "state": "NC",
            "postal_code": "27516",
            "country_code": "US",
            "telephone_number": "919-967-8844 x225",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURKERT",
        "first_name": "PATRICIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-12-30",
        "last_updated": "2019-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C012481",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chapel Hill, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2019; 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.