Tonya Michelle Wall Burnette, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-05449 Issued in NC

Practice address

1638 Owen Dr
Fayetteville, NC 28304-3424

Phone

(910) 615-8000

NPI assigned

Dec 29, 2014

Last updated

Apr 24, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Tonya Michelle Wall Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: tonyaburnette@rpf.allscriptsdirect.net

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.

• Rainbow Pediatrics of Fayetteville

  • Pediatrics Physician
  • Fayetteville, NC
  • NPI 1356439566
  NPD (past)
• Rainbow Pediatrics of Hope Mills

  • Pediatrics Physician
  • Hope Mills, NC
  • NPI 1164655932
  NPD (past)

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

{
    "created_epoch": "1419811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429833600000",
    "number": "1932597911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1638 OWEN DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043424",
            "telephone_number": "910-615-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1638 OWEN DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043424",
            "telephone_number": "910-615-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURNETTE",
        "first_name": "TONYA",
        "middle_name": "MICHELLE WALL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-29",
        "last_updated": "2015-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-05449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TONYA",
            "last_name": "WALL",
            "middle_name": "MICHELLE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jeremy Burks
• Robin Elizabeth Burks, MSW, LCSWA
• Tandeka Nix Burks, MD
• Sarah Burlee
• Amy Jean Burnett
• Wilma Smith Burnette, RRT, RCP, PSGT
• Carolyn Burnham, PHARMD
• Laura Ellen Burnham, MA, LPC, LCAS
• Jamie Burns-Keck
• Bailey Edwin Burns, DO

• Physician Assistant in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.