Individual provider Active NPI

Burnes Lynn Feaster III, MD

  • Pulmonary Disease Physician
  • St Petersburg, FL
National Provider Identifier
1083688899
Registry record updated Jun 25, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
ME50559 Issued in FL
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, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
134223953OtherFLHUMANA
4333778OtherFLAETNA
591680OtherFLUNITED
03903OtherFLBCBS
046845200MedicaidFL
17789OtherFLSTAYWELL
244715OtherFLAVMED
17789OtherFLWELLCARE
7123728OtherFLCIGNA

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050110000211 FL Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 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

Verify at the official NPI Registry.