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DR. ELWOOD JOHNSON BURGESS PSY.D. NPI 1265644637


NPI Information

NPI: 1265644637
Provider Name: DR. ELWOOD JOHNSON BURGESS, PSY.D.
Classification: Clinical Neuropsychologist - 103G00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
3824 BARRETT DR
SUITE 101
RALEIGH, NC
ZIP 27609
Phone: (919) 785-9944
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DR. Elwood Johnson Burgess, PSY.D. is a clinical neuropsychologist in Raleigh, NC with 30 years of experience. The provider is a clinical psychologist who applies principles of assessment and intervention based upon the scientific study of human behavior as it relates to normal and abnormal functioning of the central nervous system. The specialty is dedicated to enhancing the understanding of brain-behavior relationships and the application of such knowledge to human problems. DR. Elwood Johnson Burgess, PSY.D. NPI is 1265644637. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

3824 BARRETT DR
SUITE 101
RALEIGH, NC
ZIP 27609-220
Phone: (919) 785-9944
Fax: (919) 785-9992

The NPI 1265644637 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Psychiatric diagnostic evaluation (HCPCS:90791)

The enumeration date for this NPI number is 5/5/2007 and was last updated on 5/26/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1103TC0700XPsychologistClinical2249NORTH CAROLINANo
2103TC2200XPsychologistClinical Child & Adolescent2249NORTH CAROLINANo
3103TF0200XPsychologistForensic2249NORTH CAROLINANo
4103TR0400XPsychologistRehabilitation2249NORTH CAROLINANo
5103G00000XClinical Neuropsychologist2249NORTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
10310EOTHERNORTH CAROLINABCBSNC
2176TUOTHERNORTH CAROLINABC/BS EFF 2/1/2013
36000342MEDICAIDNORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.