Active NPI
Donna Jean Burdick, RD REG DIETITIAN
- Registered Dietitian
- Elmira, NY
National Provider Identifier
1801064795
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 832297
- Practice address
- 163 Sullivan St
Elmira, NY 14901-3331 - Phone
- (607) 734-6135
- Fax
- (607) 734-8918
- NPI assigned
- Feb 14, 2008
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 832297 | NY | Primary |
Addresses
Primary practice location
163 Sullivan St
Elmira, NY 14901-3331
Mailing address
163 Sullivan St
Elmira, NY 14901-3331
Phone (607) 734-6135
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 832297 | NY | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1202947200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1401408000000",
"number": "1801064795",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "163 SULLIVAN ST",
"city": "ELMIRA",
"state": "NY",
"postal_code": "149013331",
"telephone_number": "607-734-6135",
"fax_number": "607-734-8918"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "163 SULLIVAN ST",
"city": "ELMIRA",
"state": "NY",
"postal_code": "149013331",
"telephone_number": "607-734-6135",
"fax_number": "607-734-8918"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURDICK",
"first_name": "DONNA",
"middle_name": "JEAN",
"name_prefix": "Ms.",
"credential": "RD REG DIETITIAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-02-14",
"last_updated": "2014-05-30",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NY",
"license": "832297",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elmira, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.