Individual provider Active NPI

Tamara Bee Burrill, LCSW

  • Clinical Social Worker
  • Medford, OR
National Provider Identifier
1902070873
Registry record updated Apr 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L4198 Issued in OR
Practice address
1237 N Riverside Suite 229
Medford, OR 97501-0116
Phone
(541) 944-5951
Fax
(541) 858-5441
NPI assigned
Apr 22, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 28, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X L4198 OR Primary

Addresses

Primary practice location

1237 N Riverside Suite 229
Medford, OR 97501-0116

Mailing address

1049 Kensington Court
Central Point, OR 97502-2116
Phone (541) 944-5951

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
L4198ORMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1208822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209340800000",
    "number": "1902070873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1049 KENSINGTON COURT",
            "city": "CENTRAL POINT",
            "state": "OR",
            "postal_code": "975022116",
            "telephone_number": "541-944-5951",
            "fax_number": "541-858-5441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1237 N RIVERSIDE SUITE 229",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975010116",
            "telephone_number": "541-944-5951",
            "fax_number": "541-858-5441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURRILL",
        "first_name": "TAMARA",
        "middle_name": "BEE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-22",
        "last_updated": "2008-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L4198",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2008; 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.