MR. GREGORY L. BURKE (NPI# 1508841792) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508841792 |
| Entity Type | Individual |
| Full Name | MR. GREGORY L. BURKE |
| Credential | PA |
| Practice Address |
1805 Parke Plaza Circle, Suite 103 Northlake Pediatric Associates Stone Mountain GA 30087 |
| Mailing Address |
95 Collier Rd Suite 2055 Atlanta GA 30309 |
| Practice Telephone | 7704989355 |
| Practice Fax Number | 7704986294 |
| Mailing Telephone | 4046052800 |
| Mailing Fax Number | 7704986294 |
| Enumeration Date | 2005-12-09 |
| Last Update Date | 2014-01-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208000000X | Pediatrics | 002771 | GA | Allopathic & Osteopathic Physicians |
| N | 363A00000X | Physician Assistant | PA002771 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
002771 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 100000899B | 05 | |
| GA | 100000899A | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467946095 | Gregory Burke | Community Health Worker | 11 Graham Dr, Athens, OH 45701-1430 | 2018-06-18 |
| 1407940117 | Gregory William Burke | Emergency Medicine | 1798 North Garey Avenue, Pomona, CA 91767 | 2006-10-03 |
| Street Address |
1805 PARKE PLAZA CIRCLE, SUITE 103 NORTHLAKE PEDIATRIC ASSOCIATES |
| City | STONE MOUNTAIN |
| State | GA |
| Zip Code | 30087 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477176394 | Optimal Choice Telehealth | General Practice | 1227 Rockbidge Rd Sw, Ste 208-354, Stone Mountain, GA 30087 | 2020-05-27 |
| 1245882943 | Lynell Williams | Counselor | 505 Lilburn-stone Mountain Road, Suite 235, Stone Mountain, GA 30087 | 2019-07-12 |
| 1003302688 | Mark Andrew Stevens | Physical Therapist | 1227 Rockbridge Rd Ste 402, Stone Mountain, GA 30087 | 2018-07-06 |
| 1154816825 | Tuan Minh Khong | Physician Assistant | 6301 Southland Rdg, Stone Mountain, GA 30087 | 2018-06-26 |
| 1215429881 | Stephanie Martin | Nurse Practitioner | 2720 S Rockbridge Rd, Stone Mountain, GA 30087 | 2018-05-30 |
| 1578979381 | Edmund Thomas Jr. | Dentist | 2536 Rockbridge Rd Ste 103, Stone Mountain, GA 30087 | 2014-07-02 |
| 1790027688 | Robert Fanning Eaves Jr. | General Practice | 5394 Leatherstocking Lane, Stone Mountain, GA 30087 | 2013-03-19 |
| 1609128917 | Mary Marlene Muse | Lactation Consultant, Non-RN | 510 Navarre Drive, Stone Mountain, GA 30087 | 2012-10-10 |
| 1457680704 | Cleo Evans | Counselor | 5638 Manassas Run, Stone Mountain, GA 30087 | 2009-12-16 |
| 1932348521 | Lawrence Randy Sheber | Dentist | 5500-a Lilburn Stone Mountain Road, Stone Mountain, GA 30087 | 2009-02-05 |
| Find all providers in zip 30087 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932751450 | Tangenia M. Thomas | Physician Assistant | 1805 Parke Plaza Cir Ste 101, Stone Mountain, GA 30087-3646 | 2019-07-15 |
| 1205175262 | Carla N Cooke | Physician Assistant | 1805 Parke Plaza Cir, Suite 101, Stone Mountain, GA 30087-3637 | 2013-02-11 |
| 1154624013 | Kanani Daniels Floyd | Physician Assistant | 1805 Parke Plaza Cir, Suite 101, Stone Mountain, GA 30087-3637 | 2010-12-15 |
| 1265687172 | Francine S Nkoy | Physician Assistant | 1192 Rockbridge Rd Ste A, Stone Mountain, GA 30087-2923 | 2008-11-19 |
| 1134328990 | Djifa Richards Jones | Physician Assistant | 2240 W Park Place Blvd, Ste A, Stone Mountain, GA 30087-3543 | 2007-07-12 |
| 1437298056 | Seyed Mansour Jazayeri | Physician Assistant | 833 N Hairston Rd, Stone Mountain, GA 30083-3423 | 2007-02-06 |
| 1992844526 | Dawn Xin Chen | Physician Assistant | 833 N Hairston Rd, Stone Mountain, GA 30083-3423 | 2007-02-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245838374 | Erica Elizabeth West | Physician Assistant | 1155 Mount Vernon Hwy Ste 101, Atlanta, GA 30338-5439 | 2020-10-12 |
| 1801402888 | Meredith Gaines | Physician Assistant | 603 W 1st St Unit 1, Rome, GA 30161-3067 | 2020-09-16 |
| 1770108805 | Kelsey Lynne Greeff | Physician Assistant | 3400 Old Milton Pkwy Ste C, Alpharetta, GA 30005-3707 | 2020-06-15 |
| 1518596733 | Rebecca Faye Tsyrlin | Physician Assistant | 2655 Dallas Hwy Sw Ste 340, Marietta, GA 30064-7518 | 2020-04-08 |
| 1487291878 | Ashley Cohen | Physician Assistant | 250 E Ponce De Leon Ave Ste 800, Decatur, GA 30030-3438 | 2019-12-04 |
| 1932757606 | Andrea J Holley | Physician Assistant | 1629 Austin Meadows Dr, Decatur, GA 30032-3888 | 2019-08-27 |
| 1265089759 | Alexis Chester Jones | Physician Assistant | 3000 Old Alabama Rd # 128, Johns Creek, GA 30022-5860 | 2019-08-20 |
| 1841851680 | Lauren Price Fogarty | Physician Assistant | 5445 Meridian Marks Rd Ste 430, Atlanta, GA 30342-4755 | 2019-06-24 |
| 1386208262 | Jessica A Drews | Physician Assistant | 2342 Cortez Way Ne, Brookhaven, GA 30319-3914 | 2019-04-26 |
| 1174187421 | Krisna Patel | Physician Assistant | 1805 Honey Creek Cmns Se Ste B, Conyers, GA 30013-5829 | 2019-04-23 |
| Find all providers with the same taxonomy | ||||
| City | STONE MOUNTAIN |
| Zip Code | 30087 |
Please comment or provide details below to improve the information on MR. GREGORY L. 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.