Jane Davis Burgess, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0890000515 Issued in VT

Practice address

3031 Westminster Rd
Putney, VT 05346

Phone

(802) 257-8687

Fax

(802) 387-2538

NPI assigned

Mar 26, 2007

Last updated

Jul 9, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Frederick Health Hospital Inc

  dba Frederick Health Hospital

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1770601098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3031 WESTMINSTER RD",
            "city": "PUTNEY",
            "state": "VT",
            "postal_code": "05346",
            "telephone_number": "802-257-8687",
            "fax_number": "802-387-2538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3031 WESTMINSTER RD",
            "city": "PUTNEY",
            "state": "VT",
            "postal_code": "05346",
            "telephone_number": "802-257-8687",
            "fax_number": "802-387-2538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURGESS",
        "first_name": "JANE",
        "middle_name": "DAVIS",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-26",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VT",
            "license": "0890000515",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "104994",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0VN1602",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Penny Simpson Adams
• Brattleboro Memorial Hospital (Putney Family Healthcare)
• Anne Marie Briccetti, M.S.W.
• Morgan Broadfoot, PA-C, MPAS
• Andrea Carlson, LICSW
• Alana Crocker, MS, CCC-SLP
• Pauline Crouch, N.D.
• Linda Dearstyne
• Kari Lynn Dickey, D.O.

• Clinical Social Worker in Putney, VT
• Providers in Putney, VT by specialty
• Clinical Social Worker in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.