Active NPI
Brandi Lynn Burke, PA-C
- Physician Assistant
- Wright Patterson Afb, OH
National Provider Identifier
1790041226
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 4881 Sugar Maple Dr
Wright Patterson Afb, OH 45433-5529 - Phone
- (937) 257-6824
- NPI assigned
- Apr 10, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Medicine Physician | 207QA0505X | 50.006203 | OH | |
| Physician Assistant | 363A00000X | Primary |
Addresses
Primary practice location
4881 Sugar Maple Dr
Wright Patterson Afb, OH 45433-5529
Mailing address
4881 Sugar Maple Dr
Wright Patterson Afb, OH 45433-5529
Other practice location 1
Meddac-K/TMC
Unit 15609
Apo, AP 96244
Phone (820) 102-9462
Other practice location 2
Blanchfield Army Community Hospital
650 Joel Drive
Fort Campbell, KY 42223
Phone (931) 305-1954
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200402002006 | OH | Order and Referring Only - Physician Assistant | 5496184004 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 50.006203 | OH | MD | Adult Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1334016000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1726012800000",
"number": "1790041226",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4881 SUGAR MAPLE DR",
"city": "WRIGHT PATTERSON AFB",
"state": "OH",
"postal_code": "454335529"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4881 SUGAR MAPLE DR",
"city": "WRIGHT PATTERSON AFB",
"state": "OH",
"postal_code": "454335529",
"telephone_number": "937-257-6824"
}
],
"practiceLocations": [
{
"address_1": "MEDDAC-K/TMC",
"address_2": "Unit 15609",
"address_purpose": "LOCATION",
"city": "APO",
"state": "AP",
"postal_code": "96244",
"country_code": "US",
"telephone_number": "820-102-9462",
"country_name": "United States",
"address_type": "MIL"
},
{
"address_1": "Blanchfield Army Community Hospital",
"address_2": "650 Joel Drive",
"address_purpose": "LOCATION",
"city": "Fort Campbell",
"state": "KY",
"postal_code": "42223",
"country_code": "US",
"telephone_number": "931-305-1954",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BURKE",
"first_name": "BRANDI",
"middle_name": "LYNN",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-04-10",
"last_updated": "2024-09-11",
"certification_date": "2024-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "207QA0505X",
"taxonomy_group": "",
"desc": "Family Medicine, Adult Medicine",
"state": "OH",
"license": "50.006203",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wright Patterson Afb, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.