Individual provider Active NPI

Rebecca Burnham, D.O.

  • Surgery Physician
  • Summerville, SC
National Provider Identifier
1083062525
Registry record updated Aug 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
83715 Issued in SC
Practice address
295A Midland Pkwy Ste 260
Summerville, SC 29485-5901
Phone
(843) 875-8994
NPI assigned
May 25, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 83715 SC Primary

Addresses

Primary practice location

295A Midland Pkwy Ste 260
Summerville, SC 29485-5901

Mailing address

295A Midland Pkwy Ste 260
Summerville, SC 29485-5901
Phone (843) 875-8994

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211014001351 SC Practitioner - General Surgery 8628476132 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Coastal Carolina Multispecialty Associates LLCGroup PAC ID 9931105046, 48 clinicians

Practice addresses (Care Compare)

295 A Midland Pkwy
Suite 260
Summerville, SC 29485-5901
Phone (843) 695-2700

Hospital & facility affiliations

  • Trident Medical Center Hospital, Charleston, SC, CCN 420079

Merit-based Incentive Payment System (MIPS)

Final score
86.42 of 100Reported as group
Quality
78.15
Promoting interoperability
98
Improvement activities
40
Cost
73.88

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux49
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
83715SCMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Carolina Multispecialty Associates, LLC CurrentSince Sep 13, 2021 Accepting new patients
Coastal Carolina Multispecialty Assocs, LLC Past Accepting new patients

Locations

295A Midland Pkwy
Ste 260
Summerville, SC 29485
Phone (843) 695-2700

120 Medical Park Dr
Walterboro, SC 29488
Phone (843) 549-1421

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

Interoperability endpoints

  • Direct secure messaging: rebecca.burnham@hca5.eclinicaldirectplus.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1464134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629244800000",
    "number": "1083062525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "295A MIDLAND PKWY STE 260",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294855901",
            "telephone_number": "843-875-8994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "295A MIDLAND PKWY STE 260",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294855901",
            "telephone_number": "843-875-8994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURNHAM",
        "first_name": "REBECCA",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-25",
        "last_updated": "2021-08-18",
        "certification_date": "2021-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "SC",
            "license": "83715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Summerville, SC

Sources for this page

Verify at the official NPI Registry.