Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 2012-02044 | NC |
N | 207Q00000X | Family Doctor | 52437 | TN |
NPI | 1003010463 |
---|---|
Provider Name | Jennifer Elder Burgart |
First Address | Asheboro, NC 27203-4710 |
Second Address | Asheboro, NC 27203-4710 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2007 |
Last Update Date | 14/11/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
-002 -003 | TRICARE/CHAMPUS (01) | VA |
07868 | BC/BS (01) | NC |
10022001 | SENTARA/OPTIMA (01) | VA |
1003010463 | (05) | VA |
2180421 | UHC/MAMSI (01) | VA |
302882 | ANTHEM (01) | VA |
302884 | ANTHEM PFM (01) | VA |
5907686 | (05) | NC |
6039935 | BCBS TENNESSEE (01) | TN |
PAR | AETNA (01) | VA |
PAR | CIGNA (01) | VA |
PAR | CORVEL/CORCARE (01) | VA |
PAR | FIRST HEALTH COMMERCIAL/SOUTHERN HEALTH/COVENTRY (01) | VA |
PAR | MULTIPLAN (01) | VA |
PAR | USA MANAGED CARE (01) | VA |
PAR | VA HEALTH NETWORK (01) | VA |
PAR | VIRGINIA PREMIER HEALTH (01) | VA |
Q000626 | (05) | TN |