Individual provider Active NPI

Brittney Burdick, PA

  • Physician Assistant
  • Jacksonville, FL
National Provider Identifier
1780824136
Registry record updated Aug 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9111842 Issued in FL
Practice address
11513 N Main St
Jacksonville, FL 32218-4002
Phone
(904) 751-6200
Fax
(904) 751-1600
NPI assigned
Feb 25, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9111842 FL Primary
Medical Physician Assistant 363AM0700X PA.910 AL

Addresses

Primary practice location

11513 N Main St
Jacksonville, FL 32218-4002

Mailing address

2675 Winkler Ave FL 2
Fort Myers, FL 33901-9342
Phone (877) 856-3774

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, FL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20131002000130 AL Practitioner - Physician Assistant 0345399440 Reassigns benefits to 1 organization
I20190701000463 FL Practitioner - Physician Assistant 0345399440 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Millennium Physician Group LLCGroup PAC ID 9830244433, 976 clinicians

Practice addresses (Care Compare)

1065 Tamiami TRL N
Nokomis, FL 34275-2144
Phone (941) 477-2364

11513 N Main St
Jacksonville, FL 32218-4002
Phone (904) 751-6200

19531 Cochran Blvd
Port Charlotte, FL 33948-2081
Phone (941) 255-3535

2675 Winkler Ave
Fort Myers, FL 33901-9328

2675 Winkler Avenue
Suite 200
Fort Myers, FL 33901-9328

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9111842FLMDPhysician Assistant
PA.910ALMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Inpatient Consultants of Florida, Inc Physician Assistant CurrentSince Aug 24, 2019 Accepting new patients
Millennium Physician Group LLC CurrentSince Aug 8, 2022 Accepting new patients
Millennium Physician Group LLC CurrentSince Aug 8, 2022 Accepting new patients

Locations

12980 SW Highway 484
Dunnellon, FL 34432
Phone (352) 229-8465

2675 Winkler Ave
Fl 2
Fort Myers, FL 33901
Phone (855) 979-5700

11513 N Main St
Jacksonville, FL 32218
Phone (904) 751-6200

2029 Professional Center Dr
Orange Park, FL 32073
Phone (570) 352-3063

19531 Cochran Blvd
Pt Charlotte, FL 33948
Phone (941) 255-3535

6000 49th St N
St Petersburg, FL 33709
Phone (727) 521-4411

3030 W Bearss Ave
Tampa, FL 33618
Phone (813) 932-2222

Interoperability endpoints

  • Direct secure messaging: brittney.burdick.1@4290.direct.athenahealth.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/AFJGBD

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1235520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659398400000",
    "number": "1780824136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2675 WINKLER AVE FL 2",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339019342",
            "telephone_number": "877-856-3774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11513 N MAIN ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322184002",
            "telephone_number": "904-751-6200",
            "fax_number": "904-751-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURDICK",
        "first_name": "BRITTNEY",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-25",
        "last_updated": "2022-08-02",
        "certification_date": "2022-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9111842",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AL",
            "license": "PA.910",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.