JEREMY K BURDICK (NPI# 1518309350) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518309350 |
| Entity Type | Individual |
| Full Name | JEREMY K BURDICK |
| Credential | FPN |
| Practice Address |
1501 S Yale St 252 Flagstaff AZ 86001-7304 |
| Practice Telephone | 9287741811 |
| Practice Fax Number | 9287742006 |
| Mailing Telephone | 9287741811 |
| Mailing Fax Number | 9287742006 |
| Enumeration Date | 2013-07-22 |
| Last Update Date | 2013-07-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
RN125139 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1501 S YALE ST 252 |
| City | FLAGSTAFF |
| State | AZ |
| Zip Code | 86001-7304 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003811068 | Christine Crowder | General Practice | 1501 S Yale St, Bldg 2 Suite 150, Flagstaff, AZ 86001-7304 | 2005-06-16 |
| 1669911764 | North Country Healthcare, Inc. | Pediatrics | 1501 S Yale St, Ste 252, Flagstaff, AZ 86001-7304 | 2017-02-22 |
| 1174074991 | Elysia Small | Physician Assistant | 1501 S Yale St, Building 2 Suite 150, Flagstaff, AZ 86001-7304 | 2016-10-17 |
| 1578910295 | Munderloh Medical LLC | Chiropractor | 1501 S Yale St, 250, Flagstaff, AZ 86001-7304 | 2016-05-23 |
| 1326393927 | Proforma Health Pllc | Chiropractor | 1501 S Yale St, Suite 250, Flagstaff, AZ 86001-7304 | 2012-07-19 |
| 1235371493 | Travis Clark Stiegler | Psychiatry & Neurology | 1501 S Yale St, Ste 250, Flagstaff, AZ 86001-7304 | 2009-04-01 |
| 1891825022 | Michelle Doroz | Family Medicine | 1501 S Yale St, Bldg 2 Suite 150, Flagstaff, AZ 86001-7304 | 2007-03-06 |
| 1417082553 | Theresa Dowell | Physical Therapist | 1501 S Yale St, Ste# 252, Flagstaff, AZ 86001-7304 | 2007-02-22 |
| 1447397336 | Retail Automation Usa LLC | Chiropractor | 1501 S Yale St, Suite 250, Flagstaff, AZ 86001-7304 | 2007-01-31 |
| 1285703918 | Flagstaff Primary Care, PC | Pediatrics | 1501 S Yale St, Ste #252, Flagstaff, AZ 86001-7304 | 2006-11-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427658756 | Marlenne Adair Escobar-mendoza | Specialist/Technologist | 1705 South San Francisco Street, Flagstaff, AZ 86001 | 2020-10-27 |
| 1962033712 | Laura-lee Prescott | Social Worker | Northern Az Va Healthcare System, Flagstaff Cboc, 1300 W. University Ave., Suite 300, Flagstaff, AZ 86001 | 2020-01-30 |
| 1194360784 | Trinity Medical Consultants Pllc | Internal Medicine | 1521 N Cliff Drive, Flagstaff, AZ 86001 | 2019-11-07 |
| 1154849610 | Altacare, LLC | Family Medicine | 2700 S Woodlands Village Blvd Ste 700, Flagstaff, AZ 86001 | 2017-09-05 |
| 1487174926 | Lindsey Marie Forstie | Nurse Practitioner | 7263 E Dreamview Trail, Flagstaff, AZ 86001 | 2017-06-26 |
| 1255860763 | Welbrook Senior Living Flagstaff LLC | Skilled Nursing Facility | 1521 N Pine Cliff Dr, Flagstaff, AZ 86001 | 2017-06-08 |
| 1912432675 | Ryan Tiscareno | Specialist/Technologist | 621 West Cherry Ave, Flagstaff, AZ 86001 | 2017-05-01 |
| 1629432380 | Behavioral Consultation Services, Inc. | Clinic/Center | 345 S. River Run Road, Suite 200, Flagstaff, AZ 86001 | 2016-04-08 |
| 1275920928 | Junli Gallagher | Speech-Language Pathologist | 1215 N. Beaver St, Flagstaff, AZ 86001 | 2015-04-21 |
| 1932592599 | Kristen Flugstad Psyd, LLC | Psychologist | 125 East Elm Avenue #203, Flagstaff, AZ 86001 | 2015-03-06 |
| Find all providers in zip 86001 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326408527 | Taye Nelson | Nurse Practitioner | 77 W Forest Ave, Suite 304, Flagstaff, AZ 86001-1479 | 2016-03-01 |
| 1639545007 | Northern Arizona Healthcare Corporation | Nurse Practitioner | 1200 N Beaver St, Flagstaff, AZ 86001-3118 | 2015-08-19 |
| 1255480422 | Katherine Dolan Watkins | Nurse Practitioner | 2920 N 4th St, Flagstaff, AZ 86004-1816 | 2007-01-09 |
| 1518023167 | Diana E Holt | Nurse Practitioner | 107 E Oak Ave, 101, Flagstaff, AZ 86001-1818 | 2006-12-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558961425 | Christian Reese Newsom | Nurse Practitioner | 6980 E Sahuaro Dr Apt 1085, Scottsdale, AZ 85254-5295 | 2020-10-29 |
| 1083258354 | Stephenie Ann Lechuga | Nurse Practitioner | 3415 W Glendale Ave Ste 32a, Phoenix, AZ 85051-8485 | 2019-10-30 |
| 1821650201 | Rebekah Ellen Charry | Nurse Practitioner | 115 Calle Portal Ste 700, Sierra Vista, AZ 85635-2950 | 2019-07-05 |
| 1326606146 | Mollie Finn | Nurse Practitioner | 2356 N Emerald Lake Ct, Tucson, AZ 85749-7925 | 2019-06-05 |
| 1134698160 | Kayla Rose Percy | Nurse Practitioner | 1205 N F Ave, Douglas, AZ 85607-1920 | 2018-11-20 |
| 1063987683 | Katherine Anne Bassler | Nurse Practitioner | 5375 E Erickson Dr Ste 103, Tucson, AZ 85712-2838 | 2018-10-10 |
| 1134613607 | Brittany Kunz | Nurse Practitioner | 2456 E Fairview Cir, Mesa, AZ 85204-5421 | 2018-06-19 |
| 1124526884 | Kidnurse, LLC | Nurse Practitioner | 1550 S Alma School Rd Ste 275, Mesa, AZ 85210-2107 | 2018-01-29 |
| 1407354244 | Mariah Karyn White | Nurse Practitioner | 13065 W Mcdowell Rd Ste C130, Avondale, AZ 85392-6448 | 2018-01-26 |
| 1750890075 | West Valley Pediatrics | Nurse Practitioner | 10750 West Mcdowell Rd, Suite G700, Avondale, AZ 85392 | 2017-09-29 |
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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.