Shanita L Burch

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

076436-1 Issued in NY

Practice address

151 Burrs LN
Dix Hills, NY 11746-6052

Phone

(631) 643-8800

NPI assigned

Oct 23, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Maryland Wellness LLCGroup PAC ID 6406278803, 22 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Maryland Wellness LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Baltimore, MD
  • NPI 1588379739
  Medicare reassignment Care Compare group
• Samaritan Pediatric Services, P.C.

  • Pediatrics Physician
  • Babylon, NY
  • NPI 1730308925
  NPD (past)
• Sco Family of Services Dba Madonna Heights Service Clinic

  • Physical Disabilities Residential Treatment Facility
  • Garden City, NY
  • NPI 1992801062
  NPD (past)

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

{
    "created_epoch": "1287792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287792000000",
    "number": "1982904066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 WILLOUGHBY ST",
            "city": "BRENTWOOD",
            "state": "NY",
            "postal_code": "117174014",
            "telephone_number": "631-704-4155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 BURRS LN",
            "city": "DIX HILLS",
            "state": "NY",
            "postal_code": "117466052",
            "telephone_number": "631-643-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURCH",
        "first_name": "SHANITA",
        "middle_name": "L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-23",
        "last_updated": "2010-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "076436-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sheryl Ann Brodsky
• Paul Douglas Brody, M.D.
• Jennifer Bruckner
• Robert Anthony Brugna, PA-C, PHD
• Theresa Buono, RPH
• Alexandra Erica Burkes
• Jennifer Burns, COTA/L
• Leigh R Busch, DDS
• Christopher Scott Byron, CHIROPRACTOR
• Kelly C Byun, RPH

• Clinical Social Worker in Dix Hills, NY
• Providers in Dix Hills, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2010; 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.