Individual provider Active NPI

Jennifer Burky, FNP-BC

  • Family Nurse Practitioner
  • Harman, WV
National Provider Identifier
1801435359
Registry record updated Jul 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
104662 Issued in WV
Practice address
15 Mott St
Harman, WV 26270
Phone
(304) 227-4134
Fax
(855) 332-1388
NPI assigned
Jan 2, 2020
Last updated
Jul 18, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 104662 WV Primary
Registered Nurse 163W00000X 77628 WV

Addresses

Primary practice location

15 Mott St
Harman, WV 26270

Mailing address

15 Mott St
Harman, WV 26270
Phone (304) 227-4134

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20200420002171 WV Practitioner - Nurse Practitioner 8426488172 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
May accept Medicare assignment
Group practices
Pendleton Community Care IncGroup PAC ID 3678470614, shared by 9 NPIs, 11 clinicians

Practice addresses (Care Compare)

15 Mott St
Harman, WV 26270-0014
Phone (304) 227-4134

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
77628WVMDRegistered Nurse
104662WVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pendleton Community Care, Inc. Current Accepting new patients
Pendleton Community Care, Inc. CurrentSince Jan 31, 2022 Accepting new patients
Pendleton Community Care Inc CurrentSince Jan 31, 2022 Accepting new patients
Pendleton Community Care Inc CurrentSince Jan 31, 2022 Accepting new patients
Pendleton Community Care Inc Past Accepting new patients
Pendleton Community Care, Inc. Past Accepting new patients

Locations

15 Mott St
Harman, WV 26270
Phone (304) 227-4134

Interoperability endpoints

  • Direct secure messaging: jennifer.burky.1@6719.direct.athenahealth.com

Organizations & group practices 6

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 2

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": "1577923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689638400000",
    "number": "1801435359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 MOTT ST",
            "city": "HARMAN",
            "state": "WV",
            "postal_code": "26270",
            "telephone_number": "304-227-4134",
            "fax_number": "855-332-1388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 MOTT ST",
            "city": "HARMAN",
            "state": "WV",
            "postal_code": "26270",
            "telephone_number": "304-227-4134",
            "fax_number": "855-332-1388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURKY",
        "first_name": "JENNIFER",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-02",
        "last_updated": "2023-07-18",
        "certification_date": "2023-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "104662",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WV",
            "license": "77628",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harman, WV

Sources for this page

Verify at the official NPI Registry.