Individual provider Active NPI

Christopher Andrew Burks, AU. D., CCCA

  • Audiologist
  • Johnson City, TN
National Provider Identifier
1861589517
Registry record updated Mar 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
A0000001468 Issued in TN
Practice address
306 Sunset Dr
Suite 103
Johnson City, TN 37604-2492
Phone
(423) 328-9190
Fax
(423) 328-9189
NPI assigned
Oct 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X A0000001468 TN Primary

Addresses

Primary practice location

306 Sunset Dr
Suite 103
Johnson City, TN 37604-2492

Mailing address

108 E 11TH Ave
Johnson City, TN 37601-3929
Phone (423) 914-2846

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGOtherTNBLUE CROSS PROVIDER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070705000541 TN Practitioner - Qualified Audiologist 0749380707 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
East Tennessee State University Quillen College of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Appalachian Hearing and Speech Center, LLCGroup PAC ID 4183938228, 2 clinicians

Practice addresses (Care Compare)

306 Sunset Dr
Johnson City, TN 37604-2492
Phone (423) 328-9190

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
A0000001468TNMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Appalachian Hearing and Speech Center, LLC Audiologist CurrentSince Jan 3, 2015 Accepting new patients

Locations

306 Sunset Dr
Ste 103
Johnson City, TN 37604
Phone (423) 328-9190

3101 Browns Mill Rd
Ste 6
Johnson City, TN 37604
Phone (423) 408-2778

3101 Browns Mill Rd
Johnson City, TN 37604
Phone (423) 282-1100

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": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426118400000",
    "number": "1861589517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 E 11TH AVE",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376013929",
            "telephone_number": "423-914-2846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 SUNSET DR",
            "address_2": "SUITE 103",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042492",
            "telephone_number": "423-328-9190",
            "fax_number": "423-328-9189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURKS",
        "first_name": "CHRISTOPHER",
        "middle_name": "ANDREW",
        "name_prefix": "Mr.",
        "credential": "AU. D., CCCA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-06",
        "last_updated": "2015-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "TN",
            "license": "A0000001468",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PROVIDER",
            "identifier": "PENDING",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.