Individual provider Active NPI

Robert Brian Burke, LATC, EMT ,LMT

  • Athletic Trainer
  • Brookline, MA
National Provider Identifier
1831224021
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
6 Issued in MA
Practice address
115 Greenough St
Brookline, MA 02445-6151
Phone
(617) 713-5416
NPI assigned
Feb 21, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 6 MA Primary

Addresses

Primary practice location

115 Greenough St
Brookline, MA 02445-6151

Mailing address

10 Soward St.
Hopedale, MA 01747
Phone (508) 478-7373

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
Credentials
Emergency Medical Technician

State licenses

LicenseStateTypeSpecialty
6MAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1831224021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 SOWARD ST.",
            "city": "HOPEDALE",
            "state": "MA",
            "postal_code": "01747",
            "telephone_number": "508-478-7373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 GREENOUGH ST",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024456151",
            "telephone_number": "617-713-5416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURKE",
        "first_name": "ROBERT",
        "middle_name": "BRIAN",
        "name_prefix": "Mr.",
        "credential": "LATC, EMT ,LMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MA",
            "license": "6",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookline, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.