Nicole Shiree Burbank, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

M-9657 Issued in ID

Practice address

700 W Ironwood Dr Ste 175
Coeur D Alene, ID 83814-4401

Phone

(208) 625-6300

Fax

(208) 625-6301

NPI assigned

Jul 16, 2006

Last updated

May 1, 2024By 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 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in ID

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

86.65 of 100Reported as apm

Quality

89.26

Promoting interoperability

69.9

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.223001

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.

• Boundary Community Hospital

  • Critical Access Hospital
  • Bonners Ferry, ID
  • NPI 1801896683
  Medicare reassignment NPD
• Radiology Associates of North Idaho, PA

  dba Kootenai Imaging

  • Radiology Clinic/Center
  • Coeur d'Alene, ID
  • NPI 1851384416

  Diagnostic Radiology

  Medicare reassignment NPD
• Bonner General Hospital Inc.

  dba Bonner General Health

  • Critical Access Hospital
  • Sandpoint, ID
  • NPI 1154563963
  NPD
• Bonner General Hospital, Inc.

  dba Bonner General Family and Internal Medicine

  • Family Medicine Physician
  • Sandpoint, ID
  • NPI 1033737887
  NPD
• Boundary Community Hospital

  dba Boundary Community Clinics

  • Rural Health Clinic/Center
  • Bonners Ferry, ID
  • NPI 1801273552
  NPD
• Boundary Community Hospital

  • Emergency Medical Services (Emergency Medicine) Physician
  • Bonners Ferry, ID
  • NPI 1679621098

  Diagnostic Radiology

  NPD (past)
• North Idaho Imaging Center

  dba Kootenai Outpatient Imaging

  • Diagnostic Radiology Physician
  • Coeur d'Alene, ID
  • NPI 1457353450
  NPD (past)
• North Idaho MRI

  dba Kootenai MRI

  • Magnetic Resonance Imaging (MRI) Clinic/Center
  • Coeur d'Alene, ID
  • NPI 1265425029
  NPD (past)

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714521600000",
    "number": "1982621967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 W IRONWOOD DR STE 175",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838144401",
            "telephone_number": "208-625-6309",
            "fax_number": "208-625-6310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 W IRONWOOD DR STE 175",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838144401",
            "telephone_number": "208-625-6300",
            "fax_number": "208-625-6301"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2003 Kootenai Health Way",
            "address_purpose": "LOCATION",
            "city": "Coeur D Alene",
            "state": "ID",
            "postal_code": "838146051",
            "country_code": "US",
            "telephone_number": "208-625-6360",
            "fax_number": "208-625-6361",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURBANK",
        "first_name": "NICOLE",
        "middle_name": "SHIREE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-16",
        "last_updated": "2024-05-01",
        "certification_date": "2024-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NC",
            "license": "200300944",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "ID",
            "license": "M-9657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nburbank627543@direct.multicare.org",
            "affiliation": "N",
            "address_1": "700 W Ironwood Dr Ste 175",
            "city": "Coeur D Alene",
            "state": "ID",
            "country_code": "US",
            "postal_code": "838144401",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Mercedes Ann Bull, APRN
• Patricia Ann Bullick
• Erin Bundy
• Lisa Bunker, LCPC
• Christine Raye Bunton, MSW
• Kayla Burger, PT
• Heidi Burk
• Savannah Elizabeth Burk
• Lyudmila Burkart, DO
• Scott Andrew Burke, LCSW

• Diagnostic Radiology Physician in Coeur d'Alene, ID
• Providers in Coeur d'Alene, ID by specialty
• Diagnostic Radiology Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2024; 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.

Verify at the official NPI Registry.