Individual provider Active NPI

Charles David Burge, NP-C

  • Registered Nurse
  • Johns Creek, GA
National Provider Identifier
1801136551
Registry record updated Feb 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
1-111982 Issued in AL
Practice address
6325 Hospital Pkwy
Johns Creek, GA 30097-5775
Phone
(678) 474-7100
NPI assigned
Feb 18, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 18, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 1-111982 AL Primary

Addresses

Primary practice location

6325 Hospital Pkwy
Johns Creek, GA 30097-5775

Mailing address

6325 Hospital Pkwy
Johns Creek, GA 30097-5775

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
I20130529000415 GA Practitioner - Nurse Practitioner 8224276472 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1-111982ALMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Emory Specialty Associates, LLC CurrentSince Mar 1, 2013 Accepting new patients

Locations

1821 Clifton Rd NE
Atlanta, GA 30329
Phone (404) 728-6812

101 W Ponce de Leon Ave
Decatur, GA 30030
Phone (404) 778-4889

6325 Hospital Pkwy
Johns Creek, GA 30097
Phone (404) 251-1880

Interoperability endpoints

  • Direct secure messaging: cburge19628@direct.emory.org

Organizations & group practices 1

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": "1361145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361145600000",
    "number": "1801136551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6325 HOSPITAL PKWY",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300975775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6325 HOSPITAL PKWY",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300975775",
            "telephone_number": "678-474-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURGE",
        "first_name": "CHARLES",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-02-18",
        "last_updated": "2013-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AL",
            "license": "1-111982",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johns Creek, GA

Sources for this page

Verify at the official NPI Registry.