Active NPI
Burnes Lynn Feaster III, MD
- Pulmonary Disease Physician
- St Petersburg, FL
National Provider Identifier
1083688899
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pulmonary Disease Physician
- License
- ME50559
- Practice address
- 625 6TH Ave S
Ste 475
St Petersburg, FL 33701-4662 - Phone
- (727) 895-7907
- Fax
- (727) 821-5994
- NPI assigned
- Feb 16, 2006
- Last updated
- Jun 25, 2009
- 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 |
|---|---|---|---|---|
| Pulmonary Disease Physician | 207RP1001X | ME50559 | FL | Primary |
Addresses
Primary practice location
625 6TH Ave S
Ste 475
St Petersburg, FL 33701-4662
Mailing address
6006 49TH St N
Suite 310
St Petersburg, FL 33709-2148
Phone (727) 490-5040
Other identifiers 9
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 134223953 | Other | FL | HUMANA |
| 4333778 | Other | FL | AETNA |
| 591680 | Other | FL | UNITED |
| 03903 | Other | FL | BCBS |
| 046845200 | Medicaid | FL | |
| 17789 | Other | FL | STAYWELL |
| 244715 | Other | FL | AVMED |
| 17789 | Other | FL | WELLCARE |
| 7123728 | Other | FL | CIGNA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050110000211 | FL | Practitioner - Pulmonary Disease | 6103725981 | Practice locations: Bay Pines, FL |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140048000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1245888000000",
"number": "1083688899",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6006 49TH ST N",
"address_2": "SUITE 310",
"city": "ST PETERSBURG",
"state": "FL",
"postal_code": "337092148",
"telephone_number": "727-490-5040",
"fax_number": "727-490-5045"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "625 6TH AVE S",
"address_2": "STE 475",
"city": "ST PETERSBURG",
"state": "FL",
"postal_code": "337014662",
"telephone_number": "727-895-7907",
"fax_number": "727-821-5994"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FEASTER",
"first_name": "BURNES",
"middle_name": "LYNN",
"name_suffix": "III",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-16",
"last_updated": "2009-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "FL",
"license": "ME50559",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HUMANA",
"identifier": "134223953",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4333778",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED",
"identifier": "591680",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "03903",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "046845200",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STAYWELL",
"identifier": "17789",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AVMED",
"identifier": "244715",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLCARE",
"identifier": "17789",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "7123728",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in St Petersburg, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.