Active NPI
Dawn M Burgess, RNFA
- Plastic and Reconstructive Surgery Physician
- Evansville, IN
National Provider Identifier
1013164425
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic and Reconstructive Surgery Physician
- License
- 28159755A
- Practice address
- 2701 Lincoln Ave
Evansville, IN 47714-1627 - Phone
- (812) 476-4400
- Fax
- (812) 476-0300
- NPI assigned
- Aug 27, 2008
- Last updated
- Aug 27, 2008
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Plastic and Reconstructive Surgery Physician | 2086S0122X | 28159755A | IN | Primary |
Addresses
Primary practice location
2701 Lincoln Ave
Evansville, IN 47714-1627
Mailing address
2701 Lincoln Ave
Evansville, IN 47714-1627
Phone (812) 476-4400
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4116028 | Other | IN | AETNA |
| 000000085654 | Other | KY | KENTUCKY BLUE CROSS BLUE SHIELD |
| 000000085654 | Other | IN | INDIANA BLUE CROSS BLUE SHIELD |
| 221001 | Other | IN | WELBORN HEALTHCARE |
| 91107974 | Other | IL | ILLINOIS BLUE CROSS BLUE SHIELD |
| 188985 | Other | KY | HEALTHLINK PPO |
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 |
|---|---|---|---|
| 28159755A | IN | MD | Plastic and Reconstructive Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1219795200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1219795200000",
"number": "1013164425",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2701 LINCOLN AVE",
"city": "EVANSVILLE",
"state": "IN",
"postal_code": "477141627",
"telephone_number": "812-476-4400",
"fax_number": "812-476-0300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2701 LINCOLN AVE",
"city": "EVANSVILLE",
"state": "IN",
"postal_code": "477141627",
"telephone_number": "812-476-4400",
"fax_number": "812-476-0300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURGESS",
"first_name": "DAWN",
"middle_name": "M",
"credential": "RNFA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-08-27",
"last_updated": "2008-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "2086S0122X",
"taxonomy_group": "",
"desc": "Surgery, Plastic and Reconstructive Surgery",
"state": "IN",
"license": "28159755A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4116028",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KENTUCKY BLUE CROSS BLUE SHIELD",
"identifier": "000000085654",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INDIANA BLUE CROSS BLUE SHIELD",
"identifier": "000000085654",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELBORN HEALTHCARE",
"identifier": "221001",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ILLINOIS BLUE CROSS BLUE SHIELD",
"identifier": "91107974",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHLINK PPO",
"identifier": "188985",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Evansville, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.