Individual provider Active NPI

Eric Burgess, PHARMD

  • Pharmacist
  • Avon, OH
National Provider Identifier
1073898136
Registry record updated Oct 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
03129457 Issued in OH
Practice address
37820 Detroit Rd
Avon, OH 44011-2169
Phone
(440) 610-4801
NPI assigned
Oct 19, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 19, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 03129457 OH Primary

Addresses

Primary practice location

37820 Detroit Rd
Avon, OH 44011-2169

Mailing address

37820 Detroit Rd
Avon, OH 44011-2169
Phone (440) 610-4801

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
03129457OHMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1318982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318982400000",
    "number": "1073898136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37820 DETROIT RD",
            "city": "AVON",
            "state": "OH",
            "postal_code": "440112169",
            "telephone_number": "440-610-4801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37820 DETROIT RD",
            "city": "AVON",
            "state": "OH",
            "postal_code": "440112169",
            "telephone_number": "440-610-4801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURGESS",
        "first_name": "ERIC",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-10-19",
        "last_updated": "2011-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OH",
            "license": "03129457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Avon, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.