Jd Burgess
Specialist/Technologist, Athletic Trainer in Goodyear, AZ. Individual provider (NPI-1).
NPI number1326607474
StatusActive
Last updated in NPPESJun 12, 2019
Details
- NPI
- 1326607474
- Entity type
- Individual (NPI-1)
- Name
- Jd Burgess
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jun 12, 2019
- Last updated
- Jun 12, 2019
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2255A2300X | Specialist/Technologist, Athletic Trainer | 0193 | AZ | Yes |
Practice location
13635 W La Reata AveGoodyear, AZ 85395-2243
Phone 623-670-4930
Mailing address
13635 W La Reata AveGoodyear, AZ 85395-2243
Phone 623-670-4930
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All 11 Athletic Trainer providers in Goodyear · All 2,263 providers in Goodyear
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