NPIMap

Individual provider Active NPI

Shane M Burkett, CRNP

  • Family Nurse Practitioner
  • Loysburg, PA
National Provider Identifier
1750926010
Registry record updated Nov 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP020702 Issued in PA
Practice address
2230 Woodbury Pike Ste 2
Loysburg, PA 16659-9506
Phone
(814) 766-3485
Fax
(814) 766-2379
NPI assigned
Nov 11, 2019
Last updated
Nov 11, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP020702 PA Primary

Addresses

Primary practice location

2230 Woodbury Pike Ste 2
Loysburg, PA 16659-9506

Mailing address

2230 Woodbury Pike Ste 2
Loysburg, PA 16659-9506
Phone (814) 766-3485

Other practice location 1

113 June Dr
Roaring Spring, PA 16673-1209
Phone (814) 224-2537

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191231002374 PA Practitioner - Nurse Practitioner 6709210602 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Duane P DillingGroup PAC ID 7012954845, 5 clinicians

Practice addresses (Care Compare)

2230 Woodbury Pike
Suite 2
Loysburg, PA 16659-9506
Phone (814) 766-3485

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP020702PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Duane P Dilling CurrentSince Nov 11, 2019 Accepting new patients
Windber Hospital, Inc. Past Accepting new patients

Locations

2230 Woodbury Pike
#2
Loysburg, PA 16659
Phone (814) 766-3485

2230 Woodbury Pike
Ste 2
Loysburg, PA 16659
Phone (814) 766-3485

113 June Dr
Roaring Spring, PA 16673
Phone (814) 224-2533

113 June Dr
Ofc
Roaring Spring, PA 16673

Interoperability endpoints

  • Direct secure messaging: shaneburkettcrnp@coveair.medentdirect.com

Organizations & group practices 2

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.

Hospital & facility affiliations 20

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1573430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573430400000",
    "number": "1750926010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2230 WOODBURY PIKE STE 2",
            "city": "LOYSBURG",
            "state": "PA",
            "postal_code": "166599506",
            "telephone_number": "814-766-3485",
            "fax_number": "814-766-2379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2230 WOODBURY PIKE STE 2",
            "city": "LOYSBURG",
            "state": "PA",
            "postal_code": "166599506",
            "telephone_number": "814-766-3485",
            "fax_number": "814-766-2379"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "113 June Dr",
            "address_purpose": "LOCATION",
            "city": "Roaring Spring",
            "state": "PA",
            "postal_code": "166731209",
            "country_code": "US",
            "telephone_number": "814-224-2537",
            "fax_number": "814-224-2246",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURKETT",
        "first_name": "SHANE",
        "middle_name": "M",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-11-11",
        "last_updated": "2019-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP020702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loysburg, PA

Sources for this page

Verify at the official NPI Registry.