Active NPI
Olivia Carsyn Burch, FNP-C
- Family Nurse Practitioner
- Magee, MS
National Provider Identifier
1982247888
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 903579
- Practice address
- 1529 Simpson Highway 49 Ste a
Magee, MS 39111-4209 - Phone
- (601) 439-7288
- NPI assigned
- Oct 23, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 903579 | MS | Primary |
Addresses
Primary practice location
1529 Simpson Highway 49 Ste a
Magee, MS 39111-4209
Mailing address
PO Box 23666
Jackson, MS 39225-3666
Phone (601) 849-1530
Other practice location 1
360 Simpson Highway 149 Ste 370
Magee, MS 39111-3843
Phone (601) 849-1530
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 07839287 | Medicaid | MS | |
| 1P5842 | Other | MS | MEDICARE ST DOM |
| 903579 | Other | MS | MS STATE LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MS
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200207000151 | MS | Practitioner - Nurse Practitioner | 7214363431 | Reassigns benefits to 5 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Southern Diabetes Care PLLC
Practice addresses (Care Compare)
125 Earl Clark Dr
Florence, MS 39073-9411
Phone (601) 891-8657
Hospital & facility affiliations
- Magee General Hospital
- St Dominic-Jackson Memorial Hospital
- Merit Health Women'S Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Covington County Hospital | Current | Accepting new patients | |
| Gulfport 49 Imaging, LLC | Current | Accepting new patients | |
| Covington County Hospital | Current | Accepting new patients | |
| Southern Diabetes Care, PLLC | Family | Current | Accepting new patients |
| Covington County Hospital | Current | Accepting new patients | |
| Thomas R. Blackledge, Jr., MD, PA | Current | Accepting new patients |
Locations
125 Earl Clark Dr
Florence, MS 39073
Phone (601) 891-8657
10556 Highway 49
Gulfport, MS 39503
Phone (228) 539-2399
300 SE 3rd Ave
Magee, MS 39111
Phone (601) 849-5070
800 3rd St SW
Magee, MS 39111
Phone (601) 849-1918
Organizations & group practices 8
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.
-
- Rural Health Clinic/Center
- Seminary, MS
- NPI 1134435498
-
- Radiology Clinic/Center
- Gulfport, MS
- NPI 1134702301
-
- Family Medicine Physician
- Magee, MS
- NPI 1376861757
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Jackson, MS
- NPI 1306876065
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1571788800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623283200000",
"number": "1982247888",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 23666",
"city": "JACKSON",
"state": "MS",
"postal_code": "392253666",
"telephone_number": "601-849-1530",
"fax_number": "601-849-1535"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1529 SIMPSON HIGHWAY 49 STE A",
"city": "MAGEE",
"state": "MS",
"postal_code": "391114209",
"telephone_number": "601-439-7288"
}
],
"practiceLocations": [
{
"address_1": "360 Simpson Highway 149 Ste 370",
"address_purpose": "LOCATION",
"city": "Magee",
"state": "MS",
"postal_code": "391113843",
"country_code": "US",
"telephone_number": "601-849-1530",
"fax_number": "601-849-1535",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BURCH",
"first_name": "OLIVIA",
"middle_name": "CARSYN",
"name_prefix": "Mrs.",
"credential": "FNP-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-10-23",
"last_updated": "2021-06-10",
"certification_date": "2021-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MS",
"license": "903579",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "07839287",
"state": "MS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE ST DOM",
"identifier": "1P5842",
"state": "MS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MS STATE LICENSE",
"identifier": "903579",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Magee, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 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.
- 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.