Jessica A Burt, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

4305 Medical Center Dr
Suite 4305
Fayetteville, NY 13066-6638

Phone

(315) 329-7400

Fax

(315) 329-7403

NPI assigned

Jun 20, 2013

Last updated

Nov 10, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Jessica A Goodrich Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1371686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447113600000",
    "number": "1811336183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4305 MEDICAL CENTER DR",
            "address_2": "SUITE 4305",
            "city": "FAYETTEVILLE",
            "state": "NY",
            "postal_code": "130666638",
            "telephone_number": "315-329-7400",
            "fax_number": "315-329-7403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4305 MEDICAL CENTER DR",
            "address_2": "SUITE 4305",
            "city": "FAYETTEVILLE",
            "state": "NY",
            "postal_code": "130666638",
            "telephone_number": "315-329-7400",
            "fax_number": "315-329-7403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURT",
        "first_name": "JESSICA",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-20",
        "last_updated": "2015-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "GOODRICH",
            "middle_name": "A",
            "prefix": "MISS",
            "credential": "PT, DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Callahan, Flanagan & Smith Orthodontics

• Physical Therapist in Fayetteville, NY
• Providers in Fayetteville, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.