Individual provider Active NPI

Lisa A Burk, APRN

  • Adult Health Nurse Practitioner
  • Conway, SC
National Provider Identifier
1902275480
Registry record updated Oct 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
26162 Issued in SC
Practice address
1501 9TH Ave
Conway, SC 29526-4107
Phone
(843) 248-0104
NPI assigned
Sep 15, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 6279 CT
Adult Health Nurse Practitioner 363LA2200X 26162 SC Primary

Addresses

Primary practice location

1501 9TH Ave
Conway, SC 29526-4107

Mailing address

1501 9TH Ave
Conway, SC 29526-4107
Phone (843) 248-0104

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, SC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20151119000933 CT Practitioner - Nurse Practitioner 0840590030 Reassigns benefits to 2 organizations
I20231102000349 SC Practitioner - Nurse Practitioner 0840590030 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Falk Family Total Health LLCGroup PAC ID 6204257181, 3 clinicians

Practice addresses (Care Compare)

1501 9TH Ave
Conway, SC 29526-4107
Phone (843) 248-0104

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
26162SCMDHospitalist Physician
6279CTMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Superior Health Care of CT, LLC Adult Health CurrentSince Apr 21, 2017 Accepting new patients
Starling Physicians PLLC CurrentSince Jan 1, 2016 Accepting new patients
Falk Family Total Health, LLC CurrentSince Sep 20, 2023 Accepting new patients
Falk Family Chiropractic Center P.C CurrentSince Sep 20, 2023 Accepting new patients
Starling Physicians, PLLC CurrentSince Jan 1, 2016 Accepting new patients
Starling Physicians, PLLC Past Accepting new patients

Locations

100 Simsbury Rd
Avon, CT 06001
Phone (860) 659-8830

100 Retreat Ave
Ste 100
Hartford, CT 06106
Phone (860) 545-9050

300 Kensington Ave
New Britain, CT 06051
Phone (860) 224-6200

209 Main St
Southington, CT 06489
Phone (860) 329-0401

444 Wolcott Rd
Wolcott, CT 06716
Phone (203) 879-4695

1501 9th Ave
Conway, SC 29526
Phone (843) 248-0104

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1442275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696291200000",
    "number": "1902275480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 9TH AVE",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295264107",
            "telephone_number": "843-248-0104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 9TH AVE",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295264107",
            "telephone_number": "843-248-0104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURK",
        "first_name": "LISA",
        "middle_name": "A",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-15",
        "last_updated": "2023-10-03",
        "certification_date": "2023-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CT",
            "license": "6279",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "SC",
            "license": "26162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conway, SC

Sources for this page

Verify at the official NPI Registry.