PAM MARIE BURBANK (NPI# 1992003180) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992003180 |
| Entity Type | Individual |
| Full Name | PAM MARIE BURBANK |
| Credential | RN |
| Practice Address |
1900 Woodland Dr Coos Bay OR 97420-2045 |
| Practice Telephone | 5412661209 |
| Practice Fax Number | 5412664515 |
| Mailing Telephone | 5412661209 |
| Mailing Fax Number | 5412664515 |
| Enumeration Date | 2011-03-11 |
| Last Update Date | 2013-05-20 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171M00000X | Case Manager/Care Coordinator | 084053617RN | OR | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | NBMC GROUP MEDICARE NUMBER | R0000WFBTV | 01 |
| OR | NBMC GROUP TAX ID FOR BILLING | 930635514 | 01 |
| OR | NBMC GROUP NPI | 1407812365 | 01 |
| Street Address |
1900 WOODLAND DR |
| City | COOS BAY |
| State | OR |
| Zip Code | 97420-2045 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174517528 | Mary Irene Hernandez | Physical Therapist | 1900 Woodland Dr, Coos Bay, OR 97420 | 2005-08-31 |
| 1477189009 | Sandy Lynn Teeter | Nurse Practitioner | 1900 Woodland Dr, Coos Bay, OR 97420-2099 | 2020-03-16 |
| 1114564630 | Mitaliben Rajendrakumar Gor | Nurse Practitioner | 1900 Woodland Dr, Coos Bay, OR 97420-2099 | 2019-12-03 |
| 1568014942 | Nikkona Henderson | Nurse Practitioner | 1900 Woodland Dr, Coos Bay, OR 97420-2045 | 2019-07-15 |
| 1861050189 | James Murray | Dermatology | 1900 Woodland Dr, Coos Bay, OR 97420-2099 | 2019-06-01 |
| 1346803640 | Sophia Elizabeth Massey | Nurse Practitioner | 1900 Woodland Dr, Coos Bay, OR 97420-2099 | 2019-04-22 |
| 1750857090 | Alaina Therese Hendrix | Nurse Practitioner | 1900 Woodland Dr, Coos Bay, OR 97420-2099 | 2018-10-14 |
| 1801382155 | Yulia Viktorovna Whidden | Nurse Practitioner | 1900 Woodland Dr, Coos Bay, OR 97420-2099 | 2018-07-10 |
| 1124525043 | Samantha Decker | Dermatology | 1900 Woodland Dr, Coos Bay, OR 97420-2099 | 2018-04-07 |
| 1043712383 | Gregory Sopka | Physician Assistant | 1900 Woodland Dr, Coos Bay, OR 97420-2045 | 2018-03-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346880606 | Danielle Goette | Massage Therapist | 320 Central Ave Suite 226, Coos Bay, OR 97420 | 2020-01-14 |
| 1730643735 | Nicole Hand-therapeutic Massage | Massage Therapist | 3229 Broadway Avenue, Suite D, Coos Bay, OR 97420 | 2019-01-24 |
| 1528531100 | A Better Reality | Clinic/Center | 2690 N. 17th Sstreet, Coos Bay, OR 97420 | 2019-01-07 |
| 1396216883 | Elizabeth Rose Stephens | Health Educator | 97381 Newport Lane, Coos Bay, OR 97420 | 2018-12-10 |
| 1093263386 | Megan Smith | Physician Assistant | 375 Park Ave Ste 5, Coos Bay, OR 97420 | 2016-09-14 |
| 1285091884 | Richard T Rigney | Counselor | 62754 Karl Road, Coos Bay, OR 97420 | 2016-01-27 |
| 1821493032 | James Thomas Agee | Pharmacist | 2051 Newmark Avenue, Walmart Pharmacy 1880, Coos Bay, OR 97420 | 2014-10-30 |
| 1346663895 | Steven D. Richardson D.m.d. L.l.c | Dentist | 1835 Ocean Blvd Se, Coos Bay, OR 97420 | 2014-02-03 |
| 1144669243 | Michael Jason Cole | Pharmacist | 1020 South First Ave, Coos Bay, OR 97420 | 2013-06-21 |
| 1639518053 | Jonathan Thomas Small | Physical Therapist | 2645 North 17th St, Coos Bay, OR 97420 | 2013-06-19 |
| Find all providers in zip 97420 | ||||
| Taxonomy Code | 171M00000X |
| Grouping | Other Service Providers |
| Classification | Case Manager/Care Coordinator |
| A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee’s progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881889319 | Donna Chere Kifer | Case Manager/Care Coordinator | 2110 Newmark Ave, Rsvp, Coos Bay, OR 97420-2957 | 2007-09-07 |
| 1093909079 | Debra L Brookins | Case Manager/Care Coordinator | 978 Noble Ave, Coos Bay, OR 97420-3129 | 2007-08-31 |
| 1679181069 | Jodi Sue Tavernier | Case Manager/Care Coordinator | 1750 Thompson Rd, Coos Bay, OR 97420-2195 | 2020-07-21 |
| 1477161206 | Sarah Brady | Case Manager/Care Coordinator | 1750 Thompson Rd, Coos Bay, OR 97420-2195 | 2020-07-17 |
| 1942835400 | Devyn Renee Broughton | Case Manager/Care Coordinator | 281 Laclair St, Coos Bay, OR 97420-2988 | 2020-03-05 |
| 1487293593 | Cynthia Helen Edwards | Case Manager/Care Coordinator | 281 Laclair St, Coos Bay, OR 97420-2988 | 2020-01-06 |
| 1306314919 | Jennifer Lynn Swegle | Case Manager/Care Coordinator | 281 Laclair St, Coos Bay, OR 97420-2988 | 2018-11-13 |
| 1063980852 | Katelyn Nicole Simons | Case Manager/Care Coordinator | 281 Laclair St, Coos Bay, OR 97420-2988 | 2018-11-09 |
| 1063576908 | Coos County Oregon | Case Manager/Care Coordinator | 281 Laclair Street, Coos Bay, OR 97420 | 2006-12-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871104539 | Jessica Laine | Case Manager/Care Coordinator | 1724 Maple St Apt 7, North Bend, OR 97459-2171 | 2020-08-14 |
| 1083232862 | Olivia Suzanne Botsford | Case Manager/Care Coordinator | 2369 Nw Schmidt Way Apt 117, Beaverton, OR 97006-4775 | 2020-07-08 |
| 1255958674 | Kathy Hays | Case Manager/Care Coordinator | 17887 Sw Bryan Way, Beaverton, OR 97007-6728 | 2020-07-01 |
| 1437775558 | John Alan Varner | Case Manager/Care Coordinator | 5833 N Lombard St, Portland, OR 97203-4115 | 2020-06-24 |
| 1750906228 | Dwell Care LLC. | Case Manager/Care Coordinator | 1720 Nw Lovejoy St Ste 202, Portland, OR 97209-2341 | 2020-06-10 |
| 1275169393 | Celina N Taylor | Case Manager/Care Coordinator | 103 Or-82, Enterprise, OR 97828 | 2020-03-20 |
| 1710512736 | Dominic Townsend | Case Manager/Care Coordinator | 18715 Sw Blanton St, Aloha, OR 97078-1234 | 2020-03-10 |
| 1659910073 | Kristin Anne Contreras | Case Manager/Care Coordinator | 4850 Sw 11th St Apt 110, Gresham, OR 97080-7312 | 2020-01-02 |
| 1871138453 | Kedrick Starr | Case Manager/Care Coordinator | 14600 Nw Cornell Rd., Portland, OR 97229 | 2019-11-07 |
| 1043853716 | Heidi Marie Davis | Case Manager/Care Coordinator | 635 3rd Ave Sw Unit 151, Albany, OR 97321-2625 | 2019-10-24 |
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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.