DR. FRED M. BURDETTE III (NPI# 1508814054) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508814054 |
| Entity Type | Individual |
| Full Name | DR. FRED M. BURDETTE III |
| Credential | M.D. |
| Practice Address |
1920 Warm Springs Rd Ste 1009 Columbus GA 31904-8031 |
| Mailing Address |
1920 Warm Springs Rd Columbus GA 31904-8031 |
| Practice Telephone | 7065968200 |
| Practice Fax Number | 7065710207 |
| Mailing Telephone | 7065968200 |
| Mailing Fax Number | 7065710207 |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2016-11-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 018618 | GA | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000151093K | 05 | |
| AL | 154326 | 05 | |
| GA | MEDICARE PTAN | 202I782712 | 01 |
| Street Address |
1920 WARM SPRINGS RD STE 1009 |
| City | COLUMBUS |
| State | GA |
| Zip Code | 31904-8031 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275518326 | Juan Ayerdi | Surgery | 1920 Warm Springs Rd, Ste 1009, Columbus, GA 31904-8031 | 2005-12-13 |
| 1245773811 | River City Vascular Specialists | Specialist | 1920 Warm Springs Rd, Columbus, GA 31904-8031 | 2016-11-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821641457 | At Home Palliative Care, LLC | Nursing Care | 114 Enterprise Ct, Suite B, Columbus, GA 31904 | 2019-07-23 |
| 1285191049 | Shandra Ladell Grimes | Nurse Practitioner | 2300 Manchester Expwy St Francis Hospital, Suite C-001, Columbus, GA 31904 | 2019-02-27 |
| 1881161529 | Lesley Kathleen Simmons | Massage Therapist | 5402 15th Ave, Columbus, GA 31904 | 2018-10-31 |
| 1184190662 | Alphonsa Joseph | Nurse Practitioner | 2430 Brookstone Centre Parkway, Columbus, Georgia 31904, Columbus, GA 31904 | 2018-10-22 |
| 1568942704 | William Pearce Massey | Social Worker | 8851-1 Moore Road, Columbus, GA 31904 | 2018-08-17 |
| 1033696372 | Marlise V. Gray | Counselor | 2013 Devonshire Dr. Suite 115, Columbus, GA 31904 | 2018-07-19 |
| 1710418173 | Amanda Barnette Pruett | Behavioral Analyst | 200 Brookstone Centre Pkwy Bldg 200, Columbus, GA 31904 | 2017-03-27 |
| 1750833232 | Carrie Leigh Whitehead | Nurse Practitioner | 6228 Bradley Park Dr. Suite A, Columbus, GA 31904 | 2016-10-31 |
| 1609323369 | Shomika Lasha Battle | Registered Nurse | 2101 North Avenue, Columbus, GA 31904 | 2016-09-09 |
| 1952759219 | Peaceful River Home Care Agency | In Home Supportive Care | 738 Rudgate Road, Columbus, GA 31904 | 2016-05-27 |
| Find all providers in zip 31904 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891327755 | Dejuan Julius Nelson | Specialist | 4937 Mcallister Ave, Columbus, OH 43227-1447 | 2020-02-09 |
| 1306481676 | Big Heads Barber Salon | Specialist | 6161 Busch Blvd Ste 56, Columbus, OH 43229-2548 | 2019-11-11 |
| 1538723945 | Nakia Frazier | Specialist | 4913 Festival St, Columbus, GA 31907-6065 | 2019-05-01 |
| 1033772868 | Kimberly Gore Salon Inc | Specialist | 2534 Wynnton Rd Ste B, Columbus, GA 31906-2180 | 2019-04-17 |
| 1184108375 | Crystal Denise Allen | Specialist | 3029 Cleveland Ave, Columbus, OH 43224-4421 | 2018-09-24 |
| 1770074445 | Robert Tavani | Specialist | 1203 E Broad St, Columbus, OH 43205-1404 | 2018-05-29 |
| 1689191991 | Columbus Tutoring Services, LLC | Specialist | 2700 E Main St Ste 211, Columbus, OH 43209-2536 | 2017-08-28 |
| 1265985352 | Tim Jones | Specialist | 1527 Eastmeadow Pl, Columbus, OH 43235-7535 | 2016-07-26 |
| 1790148849 | Gabriel Woon | Specialist | 913 25th St., Columbus, IN 47201 | 2016-04-05 |
| 1487059606 | Wilbert Herschel Turner IIi | Specialist | 1160 Steelwood Rd, Columbus, OH 43212-1356 | 2014-10-30 |
| Find all providers in COLUMBUS | ||||
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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.