Active NPI
Tom Martin Burnside
- Mental Health Counselor
- Cincinnati, OH
National Provider Identifier
1013072974
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- I1507
- Practice address
- 417 Anderson Ferry Rd
Cincinnati, OH 45238-5285 - Phone
- (513) 922-6537
- NPI assigned
- Dec 22, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | I1507 | OH | Primary |
Addresses
Primary practice location
417 Anderson Ferry Rd
Cincinnati, OH 45238-5285
Mailing address
417 Anderson Ferry Rd
Cincinnati, OH 45238-5285
Phone (513) 922-6537
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| I1507 | OH | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166745600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1013072974",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "417 ANDERSON FERRY RD",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452385285",
"telephone_number": "513-922-6537"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "417 ANDERSON FERRY RD",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452385285",
"telephone_number": "513-922-6537"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURNSIDE",
"first_name": "TOM",
"middle_name": "MARTIN",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-22",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OH",
"license": "I1507",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cincinnati, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.