DR. EDWIN KEITH BURKETT (NPI# 1760475362) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760475362 |
| Entity Type | Individual |
| Full Name | DR. EDWIN KEITH BURKETT |
| Credential | M.D. |
| Practice Address |
359 Medical Group, 221 Third Street West Jbsa-randolph TX 78150 |
| Practice Telephone | 2106528544 |
| Mailing Telephone | 2106528544 |
| Enumeration Date | 2005-08-30 |
| Last Update Date | 2019-08-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | G78675 | CA | Allopathic & Osteopathic Physicians |
| Y | 207Q00000X | Family Medicine | 0101243098 | VA | Allopathic & Osteopathic Physicians |
| Street Address |
359 MEDICAL GROUP, 221 THIRD STREET WEST |
| City | JBSA-RANDOLPH |
| State | TX |
| Zip Code | 78150 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770045833 | Erica Renae Guevara | Physician Assistant | 559 Medial Sq, 221 Third Street West Bldg. 1040, Jbsa-randolph Afb, TX 78150 | 2019-04-05 |
| 1457803868 | Emily Newman | Dietitian, Registered | 221 Third Street West, Bldg. 999 Ste 2, Joint Base San Antonio -randolph, TX 78150 | 2016-11-02 |
| 1922411677 | Amber Drewer | Military Health Care Provider | 3rd Street West Building 1040, Randolph Afb, TX 78150 | 2014-06-10 |
| 1144652975 | Josephine Kimberly Olsen | Family Medicine | 359 Mdos/mdg, Randolph Afb, TX 78150 | 2013-08-02 |
| 1609149681 | Lucky Lusterio | Preventive Medicine | 221 3rd St. W, Randolph Afb, TX 78150 | 2012-02-21 |
| 1417120569 | Joni Hodgson | General Practice | 221 3rd Street West, Jbsa Randolph, TX 78150 | 2008-04-09 |
| 1710095724 | Katherine Justen Adamson | Physician Assistant | 12th Medical Group, 221 3rd Street West, Randolph Air Force Base, TX 78150 | 2006-08-29 |
| 1811950090 | Lidia Stana Ilcus | Internal Medicine | 359 Mdg, 221 Third Street West, Randolph Afb, TX 78150 | 2006-04-10 |
| 1013970672 | David Hamilton | Social Worker | 12mdos/sgohf, Randolph Afb, TX 78150 | 2006-04-06 |
| 1962465526 | Robert Allan Briggs | Physical Therapist | Randolph Afb Clinic, 221 3rd St W, Randolph Afb, TX 78150 | 2006-04-06 |
| Find all providers in zip 78150 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871588236 | Kyle Brandon Hudson | Family Medicine | 359 Medical Group, 221 Third Street West, Jbsa-randolph, TX 78150 | 2005-09-13 |
| 1639527096 | Ivan D Petrich | Family Medicine | 221 3rd Street West, Jbsa-randolph, TX 78150 | 2016-05-26 |
| 1073501946 | Jennifer Lynn Ravenscroft | Family Medicine | 359 Medical Group, 221 Third St. West Bldg 1040, Jbsa-randolph, TX 78150 | 2005-10-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669073599 | Julie Suzanne Rodriguez | Family Medicine | 421 W Wadley Ave Ste B, Midland, TX 79705-5368 | 2020-11-06 |
| 1871194670 | Priscilla Tehrani | Family Medicine | 615 North Loop E Unit 100, Houston, TX 77022-5934 | 2020-11-06 |
| 1821699976 | Dr. G Medical Solutions | Family Medicine | 4840 W Panther Creek Dr Ste 211, The Woodlands, TX 77381-3542 | 2020-11-05 |
| 1124629522 | Jose Reynaldo Carcamo Jr. | Family Medicine | 18568 Texas 46, Suite 1001, Spring Branch, TX 78070 | 2020-11-03 |
| 1205437662 | Angela Ekern | Family Medicine | 7421 Cordoba Dr, Austin, TX 78724-6252 | 2020-11-03 |
| 1770184020 | Kara Fenceroy | Family Medicine | 5425 Rolling Meadows Dr, Fort Worth, TX 76123-2836 | 2020-11-03 |
| 1881295327 | Courtney L Buchmeier | Family Medicine | 16620 San Pedro Ave, San Antonio, TX 78232-2327 | 2020-11-02 |
| 1003416207 | Adeline Galvez | Family Medicine | 1300 W Terrell Ave Ste 270, Fort Worth, TX 76104-2820 | 2020-10-27 |
| 1710585229 | Megan Alyse Loyd | Family Medicine | 2101 Kingsley Dr Apt 3106, Pearland, TX 77584-4118 | 2020-10-16 |
| 1104424795 | Rachel Elizabeth Whitten | Family Medicine | 614 S Business Ih 35 Ste A, New Braunfels, TX 78130-4748 | 2020-10-15 |
| Find all providers with the same taxonomy | ||||
| City | JBSA-RANDOLPH |
| Zip Code | 78150 |
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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.