SHANE M BURKETT (NPI# 1750926010) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750926010 |
| Entity Type | Individual |
| Full Name | SHANE M BURKETT |
| Credential | CRNP |
| Practice Address |
2230 Woodbury Pike Ste 2 Loysburg PA 16659-9506 |
| Practice Telephone | 8147663485 |
| Practice Fax Number | 8147662379 |
| Mailing Telephone | 8147663485 |
| Mailing Fax Number | 8147662379 |
| Enumeration Date | 2019-11-11 |
| Last Update Date | 2019-11-11 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
SP020702 | PA | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 113 June Dr, Roaring Spring, PA 166731209 | 8142242537 | 8142242246 |
| Street Address |
2230 WOODBURY PIKE STE 2 |
| City | LOYSBURG |
| State | PA |
| Zip Code | 16659-9506 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275059461 | Evalyn S Kennedy | Nurse Practitioner | 2230 Woodbury Pike Ste 2, Loysburg, PA 16659-9506 | 2017-08-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467667881 | Reed Physical Therapy, Inc. | Clinic/Center | 2230 Woodbury Pike, Ste 1, Loysburg, PA 16659 | 2007-05-10 |
| 1811073257 | Jay Bradley Reed | Physical Therapist | 2230 Woodbury Pike, Ste 1, Loysburg, PA 16659 | 2006-10-28 |
| 1114910254 | Duane Paul Dilling | Family Medicine | 2230 Woodbury Pike, Loysburg, PA 16659-9506 | 2005-08-24 |
| 1043503147 | Katie Brooke Walters | Occupational Therapist | 2230 Woodbury Pike, Suite 1, Loysburg, PA 16659-9506 | 2011-05-23 |
| 1194767426 | Duane P Dilling | Family Medicine | 2230 Woodbury Pike, Suite 2, Loysburg, PA 16659-9506 | 2006-06-12 |
| 1720048960 | Jill L Madden | Physician Assistant | 2230 Woodbury Pike, Suite 2, Loysburg, PA 16659-9506 | 2006-03-23 |
| 1265540272 | Northern Bedford County School District | Local Education Agency (LEA) | 152 Nbc Dr, Loysburg, PA 16659-9549 | 2006-08-29 |
| 1770144537 | Alternative Community Resource Program, Inc. | Community/Behavioral Health | 152 Nbc Dr, Loysburg, PA 16659-9549 | 2019-06-24 |
| 1013577196 | Alternative Community Resource Program, Inc. | Community/Behavioral Health | 217 Nbc Dr, Loysburg, PA 16659-9552 | 2019-06-19 |
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275059461 | Evalyn S Kennedy | Nurse Practitioner | 2230 Woodbury Pike Ste 2, Loysburg, PA 16659-9506 | 2017-08-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053912170 | Kaley Elizabeth Barrett | Nurse Practitioner | 418 Edgewood Dr, Lebanon, PA 17042-9109 | 2020-11-04 |
| 1891395406 | Eimy Aguilar | Nurse Practitioner | 18 Descartes Dr, Lancaster, PA 17603-8861 | 2020-11-01 |
| 1134729775 | Jacqueline A Ouma | Nurse Practitioner | 4530 Clairton Blvd, Pittsburgh, PA 15236-2112 | 2020-10-30 |
| 1932709912 | Sheri Lynn Tittelmayer | Nurse Practitioner | 1012 Rozel Ave, Southampton, PA 18966-4130 | 2020-10-28 |
| 1346849197 | Alexander F Talarico | Nurse Practitioner | 576 Broad St, Emmaus, PA 18049-3856 | 2020-10-22 |
| 1255930129 | Patrick A Foster | Nurse Practitioner | 3332 Eisenbrown Rd, Reading, PA 19605-1412 | 2020-10-22 |
| 1033718051 | Charlene Martin Wolfgang | Nurse Practitioner | 806 Megan Dr, Cranberry Twp, PA 16066-7422 | 2020-10-21 |
| 1750980728 | Jamie Simpson | Nurse Practitioner | 618 Rachelle Ct, Latrobe, PA 15650-4731 | 2020-10-21 |
| 1124627138 | Ashley G Dillard | Nurse Practitioner | 5447 Stanton Ave, Pittsburgh, PA 15206-2518 | 2020-10-21 |
| 1831798867 | Elena Khlobystova | Nurse Practitioner | 16 Carriage House Dr, Southampton, PA 18966-2225 | 2020-10-21 |
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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.