KELLY DOUGLAS BURCHETT (NPI# 1629161864) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629161864 |
| Entity Type | Individual |
| Full Name | KELLY DOUGLAS BURCHETT |
| Credential | DO |
| Practice Address |
1605 South Baltomore Suite B Kirksville MO 63501 |
| Mailing Address |
1605 South Baltimore Suite B Kirksville MO 63501 |
| Practice Telephone | 6606653599 |
| Practice Fax Number | 6606653570 |
| Mailing Telephone | 6606653599 |
| Mailing Fax Number | 6606653570 |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2020-09-09 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207YX0905X |
Otolaryngology Specialization: Otolaryngology/Facial Plastic Surgery |
2001010344 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 207392200 | 05 |
| Street Address |
1605 SOUTH BALTOMORE SUITE B |
| City | KIRKSVILLE |
| State | MO |
| Zip Code | 63501 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245855642 | Tiffany Anna Athon | Pharmacist | Hy-vee Pharmacy, 500 N Baltimore, Kirksville, MO 63501 | 2020-06-11 |
| 1649829425 | Jillian Jo Pulis | Speech-Language Pathologist | 1300 S Cottage Ave, Kirksville, MO 63501 | 2019-09-05 |
| 1023662319 | Leah Dawn Murphy | Occupational Therapy Assistant | 1705 E La Harpe St, Kirksville, MO 63501 | 2019-07-25 |
| 1902302912 | Brittney Frances Snelling | Specialist/Technologist | 26820 State Hwy 11, Kirksville, MO 63501 | 2018-03-30 |
| 1063931434 | Kara Wehmeyer | Specialist/Technologist | 100 East Normal, Kirksville, MO 63501 | 2017-09-16 |
| 1285080796 | Hawkins Boone Mecham | General Practice | 407 S Main St # 2, Kirksville, MO 63501 | 2016-05-13 |
| 1003287848 | Lacosta Gaines | Nurse Practitioner | 1607 South Baltimore, Kirksville, MO 63501 | 2015-10-19 |
| 1427442573 | Madi Hoppe | Specialist/Technologist | 23571 Crest Trail, Kirksville, MO 63501 | 2015-03-26 |
| 1407247133 | High Hope Employment Services, Inc. | Day Training, Developmentally Disabled Services | 906 East Shepherd Avenue, Kirksville, MO 63501 | 2015-02-17 |
| 1497069694 | Ella Marie Callison | Physician Assistant | 1611 S Baltimore St Ste A, Kirksville, MO 63501 | 2010-07-29 |
| Find all providers in zip 63501 | ||||
| Taxonomy Code | 207YX0905X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| Specialization | Otolaryngology/Facial Plastic Surgery |
| An otolaryngologist who specializes in the diagnosis and surgical treatment of head and neck conditions. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194876805 | Edgar N Kemp IIi | Otolaryngology | 1605 South Baltimore, Suite B, Kirksville, MO 63501 | 2007-01-16 |
| 1891983037 | Kelly D. Burchett Do LLC | Otolaryngology | 1605 South Baltimore, Suite B, Kirksville, MO 63501 | 2007-10-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407047178 | Edment, LLC | Otolaryngology | 5780 Highway 54, Suite 113, Osage Beach, MO 65065-3043 | 2007-08-07 |
| 1336209675 | Richard Hyrum Woodland | Otolaryngology | 1602 N 2nd, Clinton, MO 64735-1192 | 2006-12-09 |
| 1023120110 | James Mead Gaunt | Otolaryngology | 1710 S Lafayette Ave, Sedalia, MO 65301-7542 | 2006-08-31 |
| 1457331324 | Kent Douglas Mcintire | Otolaryngology | 1331 W 32nd St, Joplin, MO 64804 | 2006-01-18 |
| 1457351033 | Frank W Shagets | Otolaryngology | 620 W 32nd St, Suite B, Joplin, MO 64804-2549 | 2005-07-26 |
| 1407490105 | Ear Nose Throat Medical Service | Otolaryngology | 4800 Mexico Rd Ste 103, Saint Peters, MO 63376-1666 | 2019-11-05 |
| 1730539974 | Talon Maningas D.o. LLC | Otolaryngology | 620 W 32nd St Ste B, Joplin, MO 64804-2528 | 2016-06-19 |
| 1609244193 | Heather A Curtis | Otolaryngology | 6500 Hospital Dr, Hannibal, MO 63401-6890 | 2015-09-14 |
| 1730469693 | Martin Ear Nose & Throat Clinic | Otolaryngology | 37 Doctors Park, Suite 1, Cape Girardeau, MO 63703-4956 | 2011-08-24 |
| 1558661116 | Willis H Hoyt IIi | Otolaryngology | 1055 Ozark Care Dr, Suite A, Osage Beach, MO 65065-3016 | 2010-10-29 |
| Find all providers with the same taxonomy | ||||
| City | KIRKSVILLE |
| Zip Code | 63501 |
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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.