NPIMap

Organization Active NPI

Michael Burke, Psy.D. and Associates, P.C.

  • Mental Health Counselor
  • Kearney, NE
National Provider Identifier
1821189358
Registry record updated Dec 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
MICHAEL BURKE, PSY.D. AND ASSOCIATES, P.C.
Practice address
3720 Avenue a
Suite E
Kearney, NE 68847-8169
Phone
(308) 234-5644
Fax
(308) 234-5652
NPI assigned
Sep 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2008

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

Authorized official

Name
Sally J. Wegner
Title
Office Manager
Phone
(308) 234-5644

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X

Addresses

Primary practice location

3720 Avenue a
Suite E
Kearney, NE 68847-8169

Mailing address

3720 Avenue a
Suite E
Kearney, NE 68847-8169
Phone (308) 234-5644

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050426001495 NE Part B Supplier - Clinic/Group Practice 5395784698 Receives reassigned benefits from 4 practitioners
Practice locations: Kearney, NE

National Provider Directory

National Provider Directory

Locations

3720 A Ave
Ste E
Kearney, NE 68847
Phone (308) 234-5644

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228435200000",
    "number": "1821189358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3720 AVENUE A",
            "address_2": "SUITE E",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688478169",
            "telephone_number": "308-234-5644",
            "fax_number": "308-234-5652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3720 AVENUE A",
            "address_2": "SUITE E",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688478169",
            "telephone_number": "308-234-5644",
            "fax_number": "308-234-5652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL BURKE, PSY.D. AND ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-28",
        "last_updated": "2008-12-05",
        "status": "A",
        "authorized_official_last_name": "WEGNER",
        "authorized_official_first_name": "SALLY",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "308-234-5644"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kearney, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.