AMY BURBAGE (NPI# 1104061605) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104061605 |
| Entity Type | Individual |
| Full Name | AMY BURBAGE |
| Credential | PH.D |
| Practice Address |
5230 E Stop 11 Rd Ste 350 Indianapolis IN 46237-6402 |
| Mailing Address |
Po Box 781076 Detroit MI 48278-1076 |
| Practice Telephone | 3177838383 |
| Practice Fax Number | 3177826929 |
| Mailing Telephone | 3177838383 |
| Enumeration Date | 2008-12-11 |
| Last Update Date | 2019-03-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
20041902A | IN | Behavioral Health & Social Service Providers |
| N | 103TF0000X |
Psychologist Specialization: Family |
20041902A | IN | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 200953890 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 650 E Southport Rd, Suite C, Indianapolis, IN 462278592 | 3177838383 | |
| 610 E Southport Rd Ste 100, Indianapolis, IN 462278592 | 3177838383 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407418171 | Amy Burbage | Family Medicine | 1845 Cherry St, Montgomery, AL 36107-2613 | 2019-07-02 |
| Street Address |
5230 E STOP 11 RD STE 350 |
| City | INDIANAPOLIS |
| State | IN |
| Zip Code | 46237-6402 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922270123 | Katherine Desai | Social Worker | 5230 E Stop 11 Rd Ste 350, Indianapolis, IN 46237-6402 | 2008-03-27 |
| 1801392121 | Dawn Renee Battle | Social Worker | 5230 E Stop 11 Rd Ste 350, Indianapolis, IN 46237 | 2018-04-04 |
| 1942687009 | Mary Cottom Krammes | Social Worker | 5230 E Stop 11 Rd Ste 350, Indianapolis, IN 46237-6402 | 2015-04-28 |
| 1053743088 | Summer L Ibarra | Clinical Neuropsychologist | 5230 E Stop 11 Rd Ste 350, Indianapolis, IN 46237-6402 | 2013-08-01 |
| 1740535335 | Beth E Buchanan | Social Worker | 5230 E Stop 11 Rd Ste 350, Indianapolis, IN 46237-6402 | 2012-07-19 |
| 1649532490 | Jeanette Etnier | Counselor | 5230 E Stop 11 Rd Ste 350, Indianapolis, IN 46237-6402 | 2012-06-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568961902 | Ashley Marie Mitchell | Nurse Practitioner | 8111 S Emerson Ave # 101, Indianapolis, IN 46237 | 2018-02-11 |
| 1245692177 | Christopher W Gregory | Pharmacist | 8111 S Emerson Avenue, Indianapolis, IN 46237 | 2016-03-21 |
| 1558729111 | Franklin Point Dental | Clinic/Center | 6751 E Southport Rd, Suite H, Indianapolis, IN 46237 | 2016-02-10 |
| 1821460767 | Costco Wholesale Corporation | Pharmacy | 4628 E County Line Rd, Indianapolis, IN 46237 | 2015-10-29 |
| 1164894697 | Mercedes Castellanos-pitcock | Physician Assistant | 7855 S Emerson Ave Ste P, Indianapolis, IN 46237 | 2015-10-23 |
| 1013301142 | Sophia Frawley | Physical Therapist | 7855 South Emerson Avenue, Suite W, Indianepolis, IN 46237 | 2015-03-26 |
| 1154715829 | Emily Marie Prather | Specialist/Technologist | 4607 Citation Cir, Indianapolis, IN 46237 | 2015-03-20 |
| 1659794543 | Rachel Adams | Occupational Therapy Assistant | 6525 Moss Creek Place, Indianapolis, IN 46237 | 2014-01-28 |
| 1790121549 | Carol Lynn Patton | Nurse Practitioner | 8111 S Emerson Ave Fl 5, Indianapolis, IN 46237 | 2013-05-21 |
| 1255685772 | Jarron J Lincoln | Physician Assistant | 5230 E Stop 11 Rd Ste 250, Indianapolis, IN 46237 | 2012-11-06 |
| Find all providers in zip 46237 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841816048 | Christina E Maxwell Phd | Psychologist | 6337 Hollister Driive, Suite 101, Indianapolis, IN 46224-2996 | 2020-06-23 |
| 1902362619 | Geoffrey Edwards Buck | Psychologist | 9245 N Meridian St # 111, Indianapolis, IN 46260-1836 | 2019-02-18 |
| 1285128850 | Abigail Cole | Psychologist | 6314 Rucker Rd Ste A, Indianapolis, IN 46220-4800 | 2018-06-18 |
| 1558864538 | April Krowel | Psychologist | 7962 Oaklandon Rd Ste 109, Indianapolis, IN 46236 | 2018-03-15 |
| 1720515893 | Josie Gronbach | Psychologist | 50 E 91st St Ste 316, Indianapolis, IN 46240-1556 | 2017-05-18 |
| 1821469891 | Emma Carter | Psychologist | 603 E Washington St Fl 9, Indianapolis, IN 46204 | 2015-10-15 |
| 1316385081 | Megan A Orr | Psychologist | 2001 W 86th St Fl 7, Indianapolis, IN 46260-1902 | 2013-06-04 |
| 1255775490 | Psychservices Indiana LLC | Psychologist | 5924 1/2 Hillside Avenue East Dr, Indianapolis, IN 46220-2414 | 2013-04-18 |
| 1740557206 | Michael Eric O'brien | Psychologist | 5336 Elmwood Ave, Indianapolis, IN 46203-6023 | 2011-11-28 |
| 1114237336 | Greenhouse and Associates Inc. | Psychologist | 3016 Lake Shore Drive, Ste E, Indianapolis, IN 46205 | 2010-10-21 |
| Find all providers in INDIANAPOLIS | ||||
| City | INDIANAPOLIS |
| Zip Code | 46237 |
Please comment or provide details below to improve the information on AMY BURBAGE.
| 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.