JAKELL BURGESS (NPI# 1124540174) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124540174 |
| Entity Type | Individual |
| Full Name | JAKELL BURGESS |
| Credential | FNP |
| Practice Address |
56 Franklin St Waterbury CT 06706-1253 |
| Mailing Address |
9215 Town Rdg Middletown CT 06457-6554 |
| Practice Telephone | 2037096004 |
| Enumeration Date | 2017-07-12 |
| Last Update Date | 2017-07-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
7077 | CT | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
56 FRANKLIN ST |
| City | WATERBURY |
| State | CT |
| Zip Code | 06706-1253 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114929379 | Scovill Medical Group, PC | Internal Medicine | 56 Franklin St, Waterbury, CT 06706-1221 | 2005-06-01 |
| 1528676459 | Kate Marie Breiner | Physician Assistant | 56 Franklin St, Waterbury, CT 06706-1253 | 2020-07-16 |
| 1417575192 | Muhammad Tasawar Latif | Student in an Organized Health Care Education/Training Program | 56 Franklin St, Waterbury, CT 06706-1253 | 2020-07-09 |
| 1013534148 | Syed Mustajab Ahmed | Student in an Organized Health Care Education/Training Program | 56 Franklin St, Waterbury, CT 06706-1253 | 2020-07-06 |
| 1558989681 | Brooj Awan | Student in an Organized Health Care Education/Training Program | 56 Franklin St, Waterbury, CT 06706-1253 | 2020-07-06 |
| 1699398438 | Michelle Lauren Yeung | Student in an Organized Health Care Education/Training Program | 56 Franklin St, Waterbury, CT 06706-1253 | 2020-05-27 |
| 1841810967 | Diana Shapoval | Physician Assistant | 56 Franklin St, Waterbury, CT 06706-1253 | 2020-04-18 |
| 1235768649 | Sean Michael Burgwardt | Student in an Organized Health Care Education/Training Program | 56 Franklin St, Waterbury, CT 06706-1253 | 2020-04-07 |
| 1043849326 | Miguel Angel Bravo Jr. | Student in an Organized Health Care Education/Training Program | 56 Franklin St, Waterbury, CT 06706-1253 | 2020-04-07 |
| 1053948430 | Bhavya Vemuri | Student in an Organized Health Care Education/Training Program | 56 Franklin St, Waterbury, CT 06706-1253 | 2020-03-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245750538 | Sameerah Ibtisam Rehmani | Internal Medicine | St Mary's Hospital, 56 Franklin Street, Waterbury, CT 06706 | 2017-06-27 |
| 1417208448 | Sherry L Gatling | Durable Medical Equipment & Medical Supplies | 394 Mill Street, 2nd Flr N, Waterbury, CT 06706 | 2012-10-01 |
| 1144505538 | Amanda Maria Delcavo | Physician Assistant | 50 Franklin Street, Waterbury, CT 06706 | 2011-10-17 |
| 1508097031 | Lauren K Ayr-volta | Clinical Neuropsychologist | 133 Scovill Street, Suite 211, Waterbury, CT 06706 | 2009-07-31 |
| 1538206800 | John Chardavoyne | Psychiatry & Neurology | Waterbury Outpatient Clinic, 95 Scovill Street, Waterbury, CT 06706 | 2007-01-30 |
| 1922111632 | Thomas Owen Genese | Internal Medicine | 56 Franklin Street, St. Mary's Hospital - Dept of Medicine, Waterbury, CT 06706 | 2006-08-16 |
| 1013942465 | Nancy Lou Kline | Nurse Practitioner | 133 Scovill Street-waterbury Va Community Based Clinic, #203, Waterbury, CT 06706 | 2006-07-12 |
| 1366823783 | Yamini Sachan | Internal Medicine | 56 Franklin Street, Waterbury, CT 06706 | 2015-06-11 |
| 1962881896 | Daniyal Ahmed Ansari | Internal Medicine | 56 Franklin Street, Saint Mary's Hospital, Waterbury, CT 06706 | 2015-05-26 |
| 1164809885 | Vanessa N. Goyes Ruiz | Student in an Organized Health Care Education/Training Program | 56 Franklin Street, Waterbury, CT 06706 | 2015-05-01 |
| Find all providers in zip 06706 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316559248 | Agape Family Medical Center LLC | Nurse Practitioner | 1078 W Main St Ste 3, Waterbury, CT 06708-2651 | 2020-08-21 |
| 1508375080 | Christina Audet Solomito | Nurse Practitioner | 133 Scovill St Ste 306, Waterbury, CT 06706-1127 | 2017-09-27 |
| 1558886671 | Macaela Cirish | Nurse Practitioner | 3801 East Main Street, Second Floor, Waterbury, CT 06705 | 2017-08-09 |
| 1609323070 | Laila Jones | Nurse Practitioner | 170 Grandview Ave Ste 1, Waterbury, CT 06708-2577 | 2016-09-02 |
| 1124484357 | Melanie M.f. Nesprido | Nurse Practitioner | 60 Westwood Ave Ste 100, Waterbury, CT 06708-2460 | 2016-01-04 |
| 1447651690 | Matthew L Balanda | Nurse Practitioner | 1389 W Main St Ste 205, Waterbury, CT 06708-3115 | 2014-09-08 |
| 1831523638 | Eileen Anne Knox | Nurse Practitioner | 1253 W Main St, Waterbury, CT 06702-1418 | 2013-08-28 |
| 1033414867 | Steven Paul Jeske | Nurse Practitioner | 276 Highland Ave Ste A2, Waterbury, CT 06708 | 2011-01-26 |
| 1982853263 | Leah Lucarelli | Nurse Practitioner | 80 Phoenix Ave Ste 101, Waterbury, CT 06702-1418 | 2008-09-11 |
| 1891836110 | Michelle Lynn Kennedy | Nurse Practitioner | 51 N Elm St, Waterbury, CT 06702-1511 | 2007-02-09 |
| Find all providers in WATERBURY | ||||
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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.