RICHARD WAYNE BURRIS (NPI# 1790745446) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790745446 |
| Entity Type | Individual |
| Full Name | RICHARD WAYNE BURRIS |
| Credential | PA-C |
| Practice Address |
257 W Saint George Ave Grantsburg WI 54840 |
| Mailing Address |
257 W Saint George Ave Grantsburg WI 54840-7827 |
| Practice Telephone | 7154635353 |
| Practice Fax Number | 7154632753 |
| Mailing Telephone | 7154635353 |
| Enumeration Date | 2006-03-26 |
| Last Update Date | 2018-06-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 4333-23 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363A00000X | Physician Assistant | 9113 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 449390700 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3850 Park Nicollet Blvd, St Louis Park, MN 554162527 | 9529933123 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699736967 | Richard R Burris | Family Medicine | 2161hendersonville Road, Arden, NC 28704-4016 | 2006-03-28 |
| 1487652228 | Richard Gerald Burris | Family Medicine | 827 F E Sellers Hwy, Monticello, MS 39654-9378 | 2005-07-13 |
| 1548420359 | Richard Brandon Burris | Orthopaedic Surgery | 300 Tower Rd Ne Ste 200, Marietta, GA 30060-9403 | 2008-06-16 |
| Street Address |
257 W SAINT GEORGE AVE |
| City | GRANTSBURG |
| State | WI |
| Zip Code | 54840 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871576009 | Timothy P Vaughn | Nurse Anesthetist, Certified Registered | 257 W Saint George Ave, Grantsburg, WI 54840-7827 | 2005-11-22 |
| 1225635055 | Mary Frances Flaherty Baig | Nurse Practitioner | 257 W Saint George Ave, Grantsburg, WI 54840-7827 | 2020-10-05 |
| 1649811035 | Nicholas John Stevens | Physical Therapy Assistant | 257 W Saint George Ave, Grantsburg, WI 54840-7827 | 2019-10-07 |
| 1588155899 | Abigail R Anderson | Physical Therapist | 257 W Saint George Ave, Grantsburg, WI 54840-7827 | 2018-05-22 |
| 1124578810 | Neelam S. Patel | Nurse Practitioner | 257 W Saint George Ave, Grantsburg, WI 54840-7827 | 2016-10-06 |
| 1700331501 | Rhiannon Legarde | Physical Therapist | 257 W Saint George Ave, Grantsburg, WI 54840-7827 | 2016-08-22 |
| 1336590066 | Brittany Stevens Pennings | Physical Therapist | 257 W Saint George Ave, Grantsburg, WI 54840-7827 | 2016-06-23 |
| 1598130908 | Janelle R. Gomez | Dietitian, Registered | 257 W Saint George Ave, Grantsburg, WI 54840-7827 | 2015-12-10 |
| 1952702417 | Marie Sarra | Physical Therapist | 257 W Saint George Ave, Grantsburg, WI 54840-7827 | 2014-09-15 |
| 1619393279 | Sarah Motl | Dietitian, Registered | 257 W Saint George Ave, Grantsburg, WI 54840-7827 | 2014-03-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679886618 | Maria Javaid | Internal Medicine | Shalamar Link Road, Lahore, Pakistan, Shalamar Institute of Health Sciences, Lahore, PUNJAB 54840 | 2010-07-20 |
| 1508949082 | Gary L Kaefer Dds Sc | Dentist | 302 South Pine St, Grantsburg, WI 54840 | 2006-10-20 |
| 1275544967 | Christopher John Witzany | Pharmacist | 122 W. Madison Ave., Grantsburg, WI 54840 | 2006-08-10 |
| 1821425927 | Nancy Yvette Longhenry | Registered Nurse | 134 W Madison Ave, Grantsburg, WI 54840-7022 | 2013-10-03 |
| 1639174980 | Bellicose International Inc. | Durable Medical Equipment & Medical Supplies | 122 W Madison Ave, Grantsburg, WI 54840-7022 | 2005-06-14 |
| 1528625985 | Bellicose International Inc. | Pharmacy | 122 W Madison Ave, Grantsburg, WI 54840-7022 | 2019-05-21 |
| 1407365166 | Taylor James Paap | Pharmacist | 122 W Madison Ave, Grantsburg, WI 54840-7022 | 2017-09-26 |
| 1063877421 | Richelle Christianson | Registered Nurse | 134 W Madison Ave, Grantsburg, WI 54840-7022 | 2015-12-29 |
| 1952788945 | Lean On Me Home Care | In Home Supportive Care | 134 W Madison Ave, Grantsburg, WI 54840-7022 | 2015-04-29 |
| 1760896732 | Barbara Everson | Registered Nurse | 134 W Madison Ave, Grantsburg, WI 54840-7022 | 2014-06-17 |
| Find all providers in zip 54840 | ||||
| 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 |
|---|---|---|---|---|
| 1356499784 | Burnett Medical Center Inc | Physician Assistant | 257 W Saint George Ave, Grantsburg, WI 54840-7827 | 2007-01-08 |
| 1245396852 | Julie Anne Andersson | Physician Assistant | 257 W Saint George Ave, Grantsburg, WI 54840-7827 | 2006-12-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043811409 | Kristen T Razner | Physician Assistant | 2500 E Capitol Dr # 3700, Appleton, WI 54911-8735 | 2020-11-03 |
| 1659986677 | Jordana Butler | Physician Assistant | 2105 E Enterprise Ave # 101, Appleton, WI 54913-7862 | 2020-09-15 |
| 1952916108 | Nicholas Allan Lueddecke | Physician Assistant | 101709 Fence Rd, Abbotsford, WI 54405-5400 | 2020-09-14 |
| 1073127049 | Dana Van De Hey | Physician Assistant | 616 White Birch Ct, Appleton, WI 54915-4516 | 2020-09-07 |
| 1386257194 | Harrison R Pham | Physician Assistant | 214 E Florida St Apt 526, Milwaukee, WI 53204-1657 | 2020-08-31 |
| 1366055063 | Clai Bishop Catto | Physician Assistant | 902c Tainter St, Menomonie, WI 54751-1546 | 2020-08-24 |
| 1003434978 | Benjamin Alton Cuvelier | Physician Assistant | 132 Cambridge Ave Apt 407, Waukesha, WI 53188-4788 | 2020-07-08 |
| 1366060295 | Sarah Anne Cook | Physician Assistant | 850 Brinsmere Dr, Elm Grove, WI 53122-2101 | 2020-07-07 |
| 1275159428 | Breanna Evert | Physician Assistant | 2320 Parklawn Dr # C111, Waukesha, WI 53186-2954 | 2020-06-23 |
| 1376168443 | Sadie Kolodziej | Physician Assistant | 401 Dewey Dr, Stevens Point, WI 54482-9655 | 2020-06-14 |
| Find all providers with the same taxonomy | ||||
| City | GRANTSBURG |
| Zip Code | 54840 |
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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.