Gwendolyn Louise Burk

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW6333 Issued in FL

Practice address

10300 4TH St N
St Petersburg, FL 33716-3813

Phone

(561) 790-1191

NPI assigned

Jun 19, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Auto Injury EMS'S of Florida

  • Family Nurse Practitioner
  • Brandon, FL
  • NPI 1184209694

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1497830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545177600000",
    "number": "1750811998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2027 16TH ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337043921",
            "telephone_number": "813-312-3036",
            "fax_number": "813-438-8973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10300 4TH ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337163813",
            "telephone_number": "561-790-1191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURK",
        "first_name": "GWENDOLYN",
        "middle_name": "LOUISE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-19",
        "last_updated": "2018-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW6333",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOCIAL WORK",
            "identifier": "SW6333",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brandon Tyler Burgess
• Sarah C Burgess, MSN, APRN, AGNP-C
• Burghealth Inc.
• Julio Antonio Burgos
• Jason Burgun, APRN
• Burke Chiropractic, LLC
• Burke Consulting Corporation
• Christina M. Burke, PA-C
• Elizabeth Katherine Burke, ARNP
• James Lowell Burke, D.C.

• Clinical Social Worker in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2018; 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.