JASON S BURGESS (NPI# 1043201361) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1043201361 |
Entity Type | Individual |
Full Name | JASON S BURGESS |
Credential | MD |
Practice Address |
2001 Vail Avenue Ste 320 Charlotte NC 28207-1107 |
Mailing Address |
1918 Randolph Road Suite 130 Charlotte NC 28207-1107 |
Practice Telephone | 7043330741 |
Practice Fax Number | 7043333356 |
Mailing Telephone | 7043648100 |
Mailing Fax Number | 7043652073 |
Enumeration Date | 2005-11-04 |
Last Update Date | 2014-05-14 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 208600000X | Surgery | 200200093 | NC | Allopathic & Osteopathic Physicians |
Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
200200093 | NC | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NC | 891305A | 05 | |
MEDICARE | 2000396 | 01 | |
MEDICARE PIN FACULTY | 2000396D | 01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1740674084 | Jason Paul Burgess | Student in an Organized Health Care Education/Training Program | 807 W Longleaf Dr Unit 26, Auburn, AL 36832-2679 | 2015-03-25 |
1588663850 | Jason L Burgess | Chiropractor | 107 S Oak St, Mount Carmel, PA 17851-2145 | 2005-07-19 |
Street Address |
2001 VAIL AVENUE STE 320 |
City | CHARLOTTE |
State | NC |
Zip Code | 28207-1107 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1487825170 | Mercy Hospital, Inc | Clinic/Center | 2001 Vail Avenue, Cmc Mercy, Charlotte, NC 28207-1219 | 2008-03-20 |
1902028343 | Michael W. Dobson | Surgery | 2001 Vail Avenue, Ste 320, Charlotte, NC 28207-1107 | 2007-05-03 |
1992880884 | Patrick Russell Burnside | Emergency Medicine | 2001 Vail Avenue, Carolinas Medical Center-mercy Dept Em, Charlotte, NC 28207 | 2006-10-26 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1013560739 | Louis Roncaglione | Dentist | 8815 Christenbury Pkway, Concord, NC 28207 | 2019-07-22 |
1619430014 | Khrystyna Levytska | Student in an Organized Health Care Education/Training Program | Myers Park Clinic Ob/gyn, 1350 S. Kings Dr., Charlotte, NC 28207 | 2019-04-11 |
1649743584 | Carolinas Hometown Respiratory LLC | Durable Medical Equipment & Medical Supplies | 1005 South Kings Drive, Charlotte, NC 28207 | 2019-01-03 |
1023584489 | Herron and Smith Associates, Pllc | Dentist | 135 Perrin Place, Suite 100, Charlotte, NC 28207 | 2018-10-23 |
1588161640 | Lauren Mogk | Student in an Organized Health Care Education/Training Program | Myers Park Clinical Internal Medicine, 1350 S. Kings Dr., 3rd Floor, Charlotte, NC 28207 | 2018-04-06 |
1518462241 | Sarah Hollyn Carlock | Student in an Organized Health Care Education/Training Program | Myers Park Clinic Internal Medicine, 1350 S Kings Dr, 3rd Floor, Charlotte, NC 28207 | 2018-03-26 |
1083118178 | Claire Milam | Student in an Organized Health Care Education/Training Program | Cmc/department of Emergency Medicine, 100 Blythe Blvd, Charlotte, NC 28207 | 2018-03-22 |
1811422256 | Complete Care At Dartmouth LLC | Skilled Nursing Facility | 300 Province Road, Charlotte, NC 28207 | 2017-04-24 |
1063945467 | Kaitlyn O'keefe | Internal Medicine | 1350 S. Kings Dr., 3rd Floor, Myers Park Clinic Internal Medicine, Charlotte, NC 28207 | 2017-04-04 |
1811432024 | Advanced Prosthetics of Easley, Inc | Durable Medical Equipment & Medical Supplies | 2310 Randolph Rd Ste A, Charlotte, NC 28207 | 2016-12-23 |
Find all providers in zip 28207 |
Taxonomy Code | 2086S0129X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Surgery |
Specialization | Vascular Surgery |
A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1871791301 | Kathryn Lorann Davis | Surgery | 2001 Vail Ave Ste 320, Charlotte, NC 28207-1222 | 2007-07-05 |
1033141817 | Charlotte Minimally Invasive Surgical Associates Pllc | Surgery | 330 Billingsley Road, Suite 210, Charlotte, NC 28211 | 2006-07-06 |
1164770913 | Surgical Specialists of Charlotte, Pa-mercy | Surgery | 2001 Vail Ave, Suite 320, Charlotte, NC 28207-1100 | 2012-08-28 |
1790033728 | Surgical Specialists of Charlotte, Pa-pineville | Surgery | 10512 Park Rd, Suite 101, Charlotte, NC 28210-8475 | 2012-08-23 |
1003164096 | Surgical Specialists of Charlotte-university | Surgery | 101 E Wt Harris Blvd, Suite 5103, Charlotte, NC 28262-3485 | 2012-08-22 |
1285929539 | Halim Yammine | Surgery | 1001 Blythe Blvd, Ste 300 - Cardiac Surgery, Charlotte, NC 28203-5866 | 2011-06-15 |
1750528758 | Hector Crespo Soto | Surgery | 10650 Park Rd, Ste 220, Charlotte, NC 28210-8538 | 2009-01-13 |
1356507230 | Charles Briggs | Surgery | 1001 Blythe Blvd, Ste 300- Adult Cardiology, Charlotte, NC 28203-5866 | 2008-07-31 |
1447454210 | Erin Murphy | Surgery | 10650 Park Rd, Ste 220, Charlotte, NC 28210-8538 | 2007-06-13 |
1891917431 | Peter Ford | Surgery | 7800 Providence Rd, Suite 209, Charlotte, NC 28226-2952 | 2007-05-03 |
Find all providers in CHARLOTTE |
Please comment or provide details below to improve the information on JASON S BURGESS.
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.