JAMES T BURDETT (NPI# 1083684179) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083684179 |
| Entity Type | Individual |
| Full Name | JAMES T BURDETT |
| Credential | MD |
| Practice Address |
1050 W 10th St Rolla MO 65401 |
| Mailing Address |
1050 W 10th St Attn: Executive Director of Physician Clinics Rolla MO 65402 |
| Practice Telephone | 5733649000 |
| Practice Fax Number | 5734266694 |
| Mailing Telephone | 5733649000 |
| Mailing Fax Number | 5734262282 |
| Enumeration Date | 2006-01-23 |
| Last Update Date | 2019-08-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 9853 | NV | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036118822 | 05 | |
| NV | 100500798 | 05 | |
| RR MEDICARE | P00396911 | 01 | |
| IL | RR MEDICARE GRP | CE9335 | 01 |
| IL | GROUP MED | 207988 | 01 |
| Street Address |
1050 W 10TH ST |
| City | ROLLA |
| State | MO |
| Zip Code | 65401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518962570 | Donald James Mcmullin | Internal Medicine | 1050 W 10th St, Rolla, MO 65401 | 2005-06-16 |
| 1366066037 | Pcrmc Medical Group, Inc | Clinic/Center | 1050 W 10th St, Rolla, MO 65401-2905 | 2020-05-29 |
| 1659857415 | Josie Leann Eoff | Nurse Practitioner | 1050 W 10th St, Rolla, MO 65401 | 2018-07-16 |
| 1659893758 | Joshua Thomas Turnbaugh | Nurse Practitioner | 1050 W 10th St, Rolla, MO 65401 | 2017-07-10 |
| 1700327897 | Emily Wiseman | Nurse Practitioner | 1050 W 10th St, Rolla, MO 65401 | 2017-03-09 |
| 1487046181 | Pamela N. Gray | Physician Assistant | 1050 W 10th St, Rolla, MO 65401-2905 | 2015-03-04 |
| 1174928857 | Arezo Hesaraki | Dentist | 1050 W 10th St, Ste 480, Rolla, MO 65401-2905 | 2014-10-23 |
| 1922416296 | Karen Ulrich | Advanced Practice Midwife | 1050 W 10th St, Rolla, MO 65401-2905 | 2014-07-30 |
| 1093142531 | Meredith Leigh Napierala | Nurse Practitioner | 1050 W 10th St, Rolla, MO 65401-2905 | 2013-09-30 |
| 1528409638 | Curtis Morrison | Internal Medicine | 1050 W 10th St, Rolla, MO 65401-2905 | 2013-07-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639645591 | Samantha Jo Mitchell | Pharmacist | 1375 E 10th St Suite B, Rolla, MO 65401 | 2018-10-18 |
| 1427567726 | Gerry Wade Funkhouser Jr. | Counselor | 103 W 10th St, Rolla, MO 65401 | 2017-09-29 |
| 1366967960 | Shana Hintz Wisniewski | Social Worker | 1000 W. 10th St., Rolla, MO 65401 | 2017-08-04 |
| 1174066559 | Tabitha Hundt | Counselor | 1011 Cypress Dr, Rolla, MO 65401 | 2016-12-02 |
| 1841742855 | Alpha Assisted Living LLC | Assisted Living Facility | 13450 Cr 7040, 803 E 12th St, Rolla, MO 65401 | 2016-10-26 |
| 1275916884 | Elizabeth Zersen | Occupational Therapist | 2053 Vienna Rd, Rolla, MO 65401 | 2015-06-30 |
| 1386047025 | Becky L Witham | Nurse Practitioner | 1060 W 10th Street, Rolla, MO 65401 | 2014-10-08 |
| 1114326121 | Summer Adey | Licensed Practical Nurse | 13750 State Route F, Rolla, MO 65401 | 2014-08-14 |
| 1518303296 | Leaetta Mildred Gardner | Nursing Facility/Intermediate Care Facility | 13450 County Road 7040, Rolla, MO 65401 | 2013-05-21 |
| 1316282064 | Susan Peitz Gruener | Occupational Therapy Assistant | 1800 White Column Road, Rolla, MO 65401 | 2012-12-06 |
| Find all providers in zip 65401 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| 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 Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861694903 | Pamela K. Grow | Pediatrics | 1200 N Pine St, Student Health Services, Rolla, MO 65401-2831 | 2007-06-01 |
| 1053318980 | Katherine Sue Cook | Pediatrics | 700 W 11th St, Rolla, MO 65401-2102 | 2005-07-07 |
| 1295179166 | Sabin Kumar Shrestha | Pediatrics | 1050 W 10th St, Rolla, MO 65401-2905 | 2013-04-23 |
| 1598053498 | Shawna C Gifford | Pediatrics | 1050 W 10th St, Rolla, MO 65401-2905 | 2011-07-13 |
| 1942511753 | Katie Cameron | Pediatrics | 1050 W 10th St, Rolla, MO 65401-2905 | 2010-06-25 |
| 1194992172 | Evelyn Abena Oppongwaa Aboagye | Pediatrics | 1605 Martin Springs Dr, Suite 250, Rolla, MO 65401-2931 | 2008-05-09 |
| 1780852384 | Rolla Children's Clinic, P.C. | Pediatrics | 1050 W 10th St, Suite 480, Rolla, MO 65401-2905 | 2008-02-15 |
| 1942347190 | Vera Mikhailova | Pediatrics | 1100 W 10th St, Suite 175, Rolla, MO 65401-2937 | 2007-01-30 |
| 1821135070 | Suman S. Rao | Pediatrics | 1605 Martin Springs Dr, Suite 250, Rolla, MO 65401-2931 | 2007-01-30 |
| 1700923943 | Sean A. Mcenaney | Pediatrics | 1100 W 10th St, Suite 175, Rolla, MO 65401-2937 | 2007-01-30 |
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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.