JILL BURBANK (NPI# 1124117163) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124117163 |
| Entity Type | Individual |
| Full Name | JILL BURBANK |
| Credential | PA |
| Practice Address |
802 W Broadway Stafford KS 67578 |
| Mailing Address |
802 W Broadway Po Box 309 Stafford KS 67578 |
| Practice Telephone | 6202346826 |
| Practice Fax Number | 6202345014 |
| Mailing Telephone | 6202346826 |
| Mailing Fax Number | 6202345014 |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2008-01-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 1501002 | KS | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KS | BLUE CROSS BLUE SHIELD | 426817 | 01 |
| KS | 200306410A | 05 |
| Street Address |
802 W BROADWAY |
| City | STAFFORD |
| State | KS |
| Zip Code | 67578 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093896805 | Pratt Regional Medical Center Corporation | Clinic/Center | 802 W Broadway, Stafford, KS 67578 | 2006-10-18 |
| 1174612105 | Fredrick J Farmer IIi | Family Medicine | 802 W Broadway, Stafford, KS 67578 | 2006-10-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104038959 | Grene Vision Group LLC | Ophthalmology | 115 E Broadway, Stafford, KS 67578 | 2007-05-04 |
| 1669451084 | Thomas Anderson Bauer | Internal Medicine | 602 South Buckeye Avenue, Stafford, KS 67578 | 2006-01-13 |
| 1295840999 | Stafford County Hospital | General Acute Care Hospital | 502 South Buckeye Street, Stafford, KS 67578-0190 | 2006-08-20 |
| 1437258779 | Stafford County Hospital | Medicare Defined Swing Bed Unit | 502 South Buckeye Street, Stafford, KS 67578-0190 | 2006-09-22 |
| 1649331281 | Tamara L Farmer | Clinical Nurse Specialist | 802 West Broadway, Stafford, KS 67578-0309 | 2006-12-13 |
| 1750472429 | Pratt Regional Medical Center Corporation | Clinic/Center | 802 W Broadway St, Stafford, KS 67578-1402 | 2006-09-27 |
| 1902847072 | Charles L Craig | Physician Assistant | 218 S Union St, Stafford, KS 67578-1428 | 2006-06-09 |
| 1609100452 | Stafford Usd 349 | Local Education Agency (LEA) | 318 E Broadway St, Stafford, KS 67578-1807 | 2009-09-28 |
| 1033175724 | Larry D Ball | Family Medicine | 602 S Buckeye, Stafford, KS 67578-2002 | 2006-04-22 |
| 1770942526 | Mary Vineski | Occupational Therapy Assistant | 405 Grand Ave, Stafford, KS 67578-2009 | 2016-02-22 |
| Find all providers in zip 67578 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407472574 | Miriam Magdalena Robertson | Physician Assistant | 20 Brixham Ct, Stafford, VA 22554-7667 | 2020-06-24 |
| 1255823977 | Cherie Rochelle Smith | Physician Assistant | 18 Booth Ct, Stafford, VA 22554-8838 | 2018-05-30 |
| 1902847072 | Charles L Craig | Physician Assistant | 218 S Union St, Stafford, KS 67578-1428 | 2006-06-09 |
| 1629074331 | Dennis L. Fair | Physician Assistant | 422 Garrisonville Rd, Ste 111, Stafford, VA 22554-1573 | 2005-06-27 |
| 1619523222 | Brittany Elizabeth Wiseman | Physician Assistant | 125 Hospital Center Blvd Ste 221, Stafford, VA 22554-6203 | 2019-08-11 |
| 1992368310 | Taylor Monroe | Physician Assistant | 20 Doc Stone Rd, Stafford, VA 22556-4515 | 2019-04-22 |
| 1801278668 | Laura Elizabeth Erwin | Physician Assistant | 60 Prosperity Ln, Stafford, VA 22556-4605 | 2015-06-29 |
| 1649666728 | Century Pediatrics, Inc | Physician Assistant | 385 Garrisonville Rd, Stafford, VA 22554-1545 | 2015-04-15 |
| 1982904421 | Joshua T Markwell | Physician Assistant | 282 Choptank Rd, Suite 103, Stafford, VA 22556-6481 | 2010-11-01 |
| 1831423839 | Galadriel Lea Pastor | Physician Assistant | 450 Garrisonville Rd, Suite 109, Stafford, VA 22554 | 2009-09-23 |
| Find all providers in STAFFORD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.