Laura K. Burgeson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA533 Issued in ID

Practice address

1986 W Hayden Ave
Hayden, ID 83835-7412

Phone

(208) 762-7760

Fax

(208) 762-7740

NPI assigned

Apr 20, 2006

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 identifiers 6

Other names 1

• Laura K Triphahn Former name

Medicare fee-for-service enrollment

Enrolled in ID, WA2 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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: lburgeson438798@direct.multicare.org

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.

• North Idaho Nephrology Associates, Inc.

  • Medical Specialty Clinic/Center
  • Hayden, ID
  • NPI 1912181090

  ID, WA

  Medicare reassignment
• Inland Cardiology Associates, P.S.

  • Cardiovascular Disease Physician
  • Spokane, WA
  • NPI 1679522106
  NPD (past)

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

{
    "created_epoch": "1145491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623801600000",
    "number": "1962467977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1986 W HAYDEN AVE",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "838357412",
            "telephone_number": "208-762-7760",
            "fax_number": "208-762-7740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1986 W HAYDEN AVE",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "838357412",
            "telephone_number": "208-762-7760",
            "fax_number": "208-762-7740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURGESON",
        "first_name": "LAURA",
        "middle_name": "K.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-20",
        "last_updated": "2021-06-16",
        "certification_date": "2021-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA533",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807116700",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8421174",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "16666921",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7144785",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8080036",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN",
            "identifier": "1370136",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURA",
            "last_name": "TRIPHAHN",
            "middle_name": "K",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Emily Sarah Brown, DPT, OCS
• Jackson Batterson Brown, DC
• Jennie Rose Brown, PHARMD
• Tyrel J Bruneel, OD
• Mark Dana Bullock, PH.D.
• Shawn Lee Burke, PTA
• Daryll Butler, RPH
• Scout Moon-Shun Cai, DPT
• Bethany Ann Camarata, LCSW CCTP
• Julianne Jean Cameron, DO

• All providers in Hayden, ID
• Physician Assistant in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2021; 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.