DR. RANDY SCOTT BURKE (NPI# 1336173905) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336173905 |
| Entity Type | Individual |
| Full Name | DR. RANDY SCOTT BURKE |
| Credential | PH.D. |
| Practice Address |
1500 East Woodrow Wilson Drive Addictive Disorders Treatment Program (116a4), Vamc Jackson MS 39216 |
| Mailing Address |
409 Provision Pkwy Brandon MS 39042-7909 |
| Practice Telephone | 6013624471 |
| Practice Fax Number | 6013641298 |
| Mailing Telephone | 6013624471 |
| Mailing Fax Number | 6013641298 |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TA0400X |
Psychologist Specialization: Addiction (Substance Use Disorder) |
40-13 | MS | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083250856 | Randy Burke | Assisted Living Facility | 315 E Stone St, Sturgeon, MO 65284-8907 | 2019-11-26 |
| Street Address |
1500 EAST WOODROW WILSON DRIVE ADDICTIVE DISORDERS TREATMENT PROGRAM (116A4), VAMC |
| City | JACKSON |
| State | MS |
| Zip Code | 39216 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467607416 | Choon-man Joseph Kim | Nuclear Medicine | 1500 East Woodrow Wilson Drive, Radiology Service, G.v. Montgomery Va Medical Center, Jackson, MS 39216 | 2008-11-18 |
| 1548422967 | Sommer L Rodrigue | Speech-Language Pathologist | 1500 East Woodrow Wilson Drive, Gv Sonny Montgomery Department of Veterans Affairs, Jackson, MS 39216-5199 | 2008-06-26 |
| 1851452080 | Alvin Wayne Rembert | Dentist | 1500 East Woodrow Wilson Drive, Jackson, MS 39216 | 2006-12-12 |
| 1134218076 | Andre' Badelle Robinson | Occupational Therapist | 1500 East Woodrow Wilson Drive, Jackson, MS 39216-5199 | 2006-10-11 |
| 1730274887 | Department of Veterans Affairs | Dietitian, Registered | 1500 East Woodrow Wilson Drive, Jackson, MS 39216-5199 | 2006-10-04 |
| 1639263924 | Liep H Tjeng | Rehabilitation Practitioner | 1500 East Woodrow Wilson Drive, Jackson, MS 39216 | 2006-10-03 |
| 1306930680 | Cecilia D Fowler | Occupational Therapist | 1500 East Woodrow Wilson Drive, Jackson, MS 39216 | 2006-10-03 |
| 1336232529 | Jesse Ivy Garrett IIi | Pharmacist | 1500 East Woodrow Wilson Drive, Jackson, MS 39216-9765 | 2006-10-02 |
| 1871694240 | Julie Larae Robbins | Nursing Facility/Intermediate Care Facility | 1500 East Woodrow Wilson Drive, Jackson, MS 39206 | 2006-09-26 |
| 1396843694 | Ruby Ellis Denson | Nurse Practitioner | 1500 East Woodrow Wilson Drive, Jackson, MS 39216-5199 | 2006-09-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861011553 | Ashley Melancon Prewitt | Registered Nurse | St. Dominic's North Campus, Behavioral Health, Jackson, MS 39216 | 2020-04-13 |
| 1194353391 | Brianna Arrington | Student in an Organized Health Care Education/Training Program | Med/ Peds, 2500 N. State St., Jackson, MS 39216 | 2020-04-01 |
| 1720616485 | Roshina Khalid Khan | Student in an Organized Health Care Education/Training Program | Department of Anesthesiology, Ummc, 2500 N. State St., Jackson, MS 39216 | 2020-03-30 |
| 1275183550 | Amanda Lynn Morellato | Dentist | Ummc School of Dentistry, 2500 North State Street, Jackson, MS 39216 | 2019-09-18 |
| 1396305553 | Abhishek Chhabra | Student in an Organized Health Care Education/Training Program | Lakeland Family Medicine Clinic, 878 Lakeland Dr., Jackson, MS 39216 | 2019-06-19 |
| 1427615996 | Hometown Diagnostics | Clinical Medical Laboratory | Translational Research Center Tr311, 2500 North State Street, Jackson, MS 39216 | 2019-05-21 |
| 1346807773 | Shukundala C Smith | Behavior Technician | New Learning Resources 2510 Lakeland Terrace, Jackson, MS 39216 | 2019-05-21 |
| 1063901098 | G Eli Howell Md Pllc | Plastic Surgery | 971 Lakeland Dr Ste 225, Jackson, MS 39216 | 2018-05-04 |
| 1588168132 | Caleb Zumbro | Student in an Organized Health Care Education/Training Program | Ummc Med/peds, 2500 N. State St., Jackson, MS 39216 | 2018-03-20 |
| 1639677230 | Walgreen Co | Pharmacy | 971 Lakeland Dr Ste 101, Jackson, MS 39216 | 2018-01-29 |
| Find all providers in zip 39216 | ||||
| Taxonomy Code | 103TA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033629209 | Rebecca J Reed | Psychologist | 3003 Riverside Dr, Jackson, TN 38301-9160 | 2017-10-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730663469 | Essential Touchtones | Psychologist | 210 W. Jackson Street, Ridgeland, MS 39157 | 2018-09-19 |
| 1780127845 | Journeypure Mississippi Medical Group LLC | Psychologist | 8829 Centre St, Southaven, MS 38671-2610 | 2016-11-22 |
| 1780077925 | Tonna Gaines | Psychologist | 1701 White St, Mccomb, MS 39648-2711 | 2015-03-12 |
Please comment or provide details below to improve the information on DR. RANDY SCOTT BURKE.
| 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.