Active NPI
Bruce Aaron Burke, P.A.-C
- Physician Assistant
- Ripley, TN
National Provider Identifier
1780632364
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 1108083
- Practice address
- 313 Cleveland St
Ripley, TN 38063-1205 - Phone
- (731) 625-6000
- NPI assigned
- May 5, 2006
- Last updated
- Aug 7, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 1108083 | Primary |
Addresses
Primary practice location
313 Cleveland St
Ripley, TN 38063-1205
Mailing address
313 Cleveland St
Ripley, TN 38063-1205
Phone (731) 635-6000
Other practice location 1
100 Brewster Blvd
Camp Lejeune, NC 28547-2538
Phone (910) 449-0449
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
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4079 | TN | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thrive Family Healthcare, PLLC | Current | Accepting new patients | |
| Redmed, LLC | Past | Accepting new patients | |
| Redmed, LLC | Past | Accepting new patients |
Locations
313 Cleveland St
Ripley, TN 38063
Phone (731) 635-6000
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/CIAIDD
Organizations & group practices 3
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.
-
dba Thrive Family Healthcare
- Family Medicine Physician
- Ripley, TN
- NPI 1336938059
-
- Durable Medical Equipment & Medical Supplies
- Oxford, MS
- NPI 1679305031
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146787200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1659830400000",
"number": "1780632364",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "313 CLEVELAND ST",
"city": "RIPLEY",
"state": "TN",
"postal_code": "380631205",
"telephone_number": "731-635-6000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "313 CLEVELAND ST",
"city": "RIPLEY",
"state": "TN",
"postal_code": "380631205",
"telephone_number": "731-625-6000"
}
],
"practiceLocations": [
{
"address_1": "100 Brewster Blvd",
"address_purpose": "LOCATION",
"city": "Camp Lejeune",
"state": "NC",
"postal_code": "285472538",
"country_code": "US",
"telephone_number": "910-449-0449",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BURKE",
"first_name": "BRUCE",
"middle_name": "AARON",
"credential": "P.A.-C",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-05-05",
"last_updated": "2022-08-07",
"certification_date": "2022-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": "1108083",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ripley, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.