DEREK L BURT (NPI# 1811903321) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811903321 |
| Entity Type | Individual |
| Full Name | DEREK L BURT |
| Credential | NP |
| Practice Address |
17325 Van Wagoner Rd Spring Lake MI 49456-9702 |
| Practice Telephone | 6168475145 |
| Mailing Telephone | 6168475145 |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2013-06-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 4704216633 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BCBSM | 500F111460 | 01 |
| MI | 4935522 | 05 |
| Street Address |
17325 VAN WAGONER RD |
| City | SPRING LAKE |
| State | MI |
| Zip Code | 49456-9702 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336188556 | Katherine Ann Jawor | Psychiatry & Neurology | 17325 Van Wagoner Rd, Spring Lake, MI 49456-9702 | 2006-06-05 |
| 1538768643 | Karen Jean Alkema | Counselor | 17325 Van Wagoner Rd, Spring Lake, MI 49456-9702 | 2020-10-20 |
| 1467840553 | Pine Rest Christian Mental Health Services | Nurse Practitioner | 17325 Van Wagoner Rd, Spring Lake, MI 49456-9702 | 2014-12-26 |
| 1508119892 | Jordan Charles Engelhard | Psychologist | 17325 Van Wagoner Rd, Spring Lake, MI 49456-9702 | 2012-10-24 |
| 1346523131 | Sara Nicole Patzer | Social Worker | 17325 Van Wagoner Rd, Spring Lake, MI 49456-9702 | 2011-09-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376066001 | Kathleen Ann Bates | Nurse Practitioner | 16036 Baird Dr, Spring Lake, MI 49456 | 2017-07-25 |
| 1174859763 | David A Buursma | Physical Therapist | 16140 148th Avenue, Spring Lake Community Fitness & Aquatic Center, Spring Lake, MI 49456 | 2009-11-02 |
| 1720314552 | Arthur Linwood Brown II | Surgery | 18925 North Shore Dr., Spring Lake, MI 49456 | 2009-10-29 |
| 1700050531 | Ann Holmgren Harris | Clinical Nurse Specialist | 17353 Hazel St, Suite 212, Spring Lake, MI 49456 | 2008-04-14 |
| 1932320421 | Julie A Bench | Physical Therapist | 15414 Stoneridge Ct, Spring Lake, MI 49456 | 2007-05-01 |
| 1730304130 | Phillip Allen Morse | Pharmacist | 603 E Savidge, Spring Lake, MI 49456 | 2007-04-13 |
| 1821125592 | Patrick Scott Karwowski | Pharmacist | 603 E Savidge St, Spring Lake, MI 49456 | 2007-02-28 |
| 1528126521 | Debra Kaye Cargo | Social Worker | 107 South Division, Spring Lake, MI 49456 | 2006-12-04 |
| 1396821377 | Hometown Pharmacy Inc | Pharmacy | 17717 174th Ave, Spring Lake, MI 49456 | 2006-10-31 |
| 1710071360 | Link Dephouse | Physical Therapist | 16200 Old Orchard Dr, Spring Lake, MI 49456 | 2006-10-03 |
| Find all providers in zip 49456 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316409857 | Walter Hill Elliott Iv | Nurse Practitioner | 2 Royal Court Dr Apt C17, Spring Lake, NJ 07762-2338 | 2019-04-03 |
| 1467840553 | Pine Rest Christian Mental Health Services | Nurse Practitioner | 17325 Van Wagoner Rd, Spring Lake, MI 49456-9702 | 2014-12-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477154599 | Kelly Phuong Doan | Nurse Practitioner | 27327 23 Mile Rd, Chesterfield, MI 48051-2045 | 2020-11-04 |
| 1275133217 | Maureen Mae Lewis | Nurse Practitioner | 2782 N Coleman Rd, Coleman, MI 48618-9721 | 2020-10-29 |
| 1073113460 | Taylor L Pichette | Nurse Practitioner | 758 Lucille Dr, Wolverine Lake, MI 48390-2327 | 2020-10-27 |
| 1295333938 | Amanda Covell | Nurse Practitioner | 624 Cherry St Se Apt 5, Grand Rapids, MI 49503-4778 | 2020-10-14 |
| 1689271314 | Nicole Conklin | Nurse Practitioner | 524 Doyle Rd, Laingsburg, MI 48848-9611 | 2020-10-06 |
| 1447857677 | Shelby Lynn Waibel | Nurse Practitioner | 560 W Mitchell St Ste 210, Petoskey, MI 49770-2276 | 2020-10-01 |
| 1497361638 | Amira Aljamal | Nurse Practitioner | 4601 Shenandoah Ave, Allen Park, MI 48101-3131 | 2020-09-22 |
| 1659987014 | Sean Thomas Kane | Nurse Practitioner | 13734 Parallel Ave, Alpena, MI 49707-7987 | 2020-09-21 |
| 1235743592 | Mojica, LLC | Nurse Practitioner | 4163 W Pointe Dr, Waterford, MI 48329-4648 | 2020-09-03 |
| 1942812094 | Meagan James | Nurse Practitioner | 407 E Huron River Dr, Belleville, MI 48111-2763 | 2020-08-20 |
| Find all providers with the same taxonomy | ||||
| City | SPRING LAKE |
| Zip Code | 49456 |
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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.