Individual provider Active NPI

Justin Price Burgett, FNP-BC, RN

  • Family Nurse Practitioner
  • Dalton, GA
National Provider Identifier
1801061452
Registry record updated Sep 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN233030 Issued in GA
Practice address
1114 Professional Blvd
Dalton, GA 30720-2597
Phone
(706) 278-0138
NPI assigned
Apr 24, 2008
Last updated
Sep 3, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN233030 GA Primary
Registered Nurse 163W00000X 163538 TN
Registered Nurse 163W00000X RN233030 GA

Addresses

Primary practice location

1114 Professional Blvd
Dalton, GA 30720-2597

Mailing address

1114 Professional Blvd
Dalton, GA 30720-2597
Phone (706) 278-0138

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20191014002842 GA Practitioner - Nurse Practitioner 2466783915 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
Dalton Family Practice, P.C.Group PAC ID 6103817572, 8 clinicians

Practice addresses (Care Compare)

1114 Professional Blvd
Dalton, GA 30720-2588
Phone (706) 278-0138

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN233030GAMDRegistered Nurse
163538TNMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Dalton Family Practice, P.C. CurrentSince Sep 1, 2019 Accepting new patients
Hamilton Physician Group Inc PastSince Sep 1, 2019 Accepting new patients

Locations

1114 Professional Blvd
Dalton, GA 30720
Phone (706) 278-0138

Interoperability endpoints

  • Direct secure messaging: jburgett31933@hhcs.direct-ci.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 3

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

NPI Registry JSON

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

{
    "created_epoch": "1208995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567468800000",
    "number": "1801061452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1114 PROFESSIONAL BLVD",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307202597",
            "telephone_number": "706-278-0138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1114 PROFESSIONAL BLVD",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307202597",
            "telephone_number": "706-278-0138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURGETT",
        "first_name": "JUSTIN",
        "middle_name": "PRICE",
        "credential": "FNP-BC, RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-24",
        "last_updated": "2019-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN233030",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "163538",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN233030",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dalton, GA

Sources for this page

Verify at the official NPI Registry.