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Jacob David Burkart

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

4350 Us 421 S, Lillington, NC 27546-6760

PECOS Enrollment

This provider is enrolled in PECOS as JACOB BURKART.

Based on the most recent information from CMS, provider Jacob David Burkart is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1457949448
Provider Type
Individual
Full Name
Burkart, Jacob David
Title
Mr.

Gender
Male
Sole Proprietor
No
Enumeration Date
1/5/2021
Last Updated
12/8/2021

Contact Information

Practice Location

4350 Us 421 S, Lillington, NC 27546-6760

1210910893

Unlisted Fax

Mailing Location

3548 Ambition Rd, Fayetteville, NC 28306-9033

(509) 998-3045

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363A00000X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License 2521 West Virginia
Code 390200000X	Description Student in an Organized Health Care Education/Training Program Student, Health Care	License Unlisted Issuer

Jacob David Burkart

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Ovens, Leonard R.

Young, Rebecca Klein

Bernardo-Pollock, Leny Vanessa

Han, Christine

Price, Anne

Mountcastle, Brandy Norris

Cothran, Ashley L

Goo, Bianca L

Mcneill, Kaitlin Briana

Johnson, Tiy