Active NPI
Mark Lloyd Burson, M.D.
- Urology Physician
- Macon, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- 36112
- Practice address
- 330 Hospital Dr Ste 315
Macon, GA 31217-8042 - Phone
- (478) 742-5331
- NPI assigned
- Nov 15, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | 0101265824 | VA | |
| Urology Physician | 208800000X | CDR.0004667 | CO | |
| Urology Physician | 208800000X | 40439 | TN | |
| Urology Physician | 208800000X | 36112 | GA | Primary |
Addresses
Primary practice location
330 Hospital Dr Ste 315
Macon, GA 31217-8042
Mailing address
330 Hospital Dr Ste 315
Macon, GA 31217-8042
Other practice location 1
1802 Braeburn Dr
Salem, VA 24153-7357
Phone (540) 772-3702
Other practice location 2
107 Ledford Mill Rd
Tullahoma, TN 37388-2278
Phone (931) 454-1955
Other practice location 3
1010 Three Springs Blvd Ste 270
Durango, CO 81301-8296
Phone (970) 764-3845
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4116328 | Other | TN | BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN, GA, AL, VA, MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 5
Care Compare profile
Medicare Care Compare- Specialty
- Urology
- Education
- Other, 1980
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
330 Hospital Dr
Suite 315
Macon, GA 31217-8042
Phone (478) 742-5331
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CDR.0004667 | CO | MD | Urology Physician |
| 36112 | GA | MD | Urology Physician |
| 40439 | TN | MD | Urology Physician |
| 0101265824 | VA | MD | Urology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lakeland Medical Practices | Current | Accepting new patients | |
| Lewis Gale Physicians LLC | Current | Accepting new patients | |
| Wellmont Medical Associates Inc | Current | Accepting new patients | |
| Wiregrass Clinic LLC | Urology | Current | Accepting new patients |
| Lakeland Medical Practices | Current | Accepting new patients | |
| Wellmont Medical Associates, Inc. | Current | Accepting new patients | |
| Urology of Greater Atlanta LLC | Past | Accepting new patients |
Locations
4300 W Main St
Ste 21
Dothan, AL 36305
Phone (334) 699-7900
815 Saint Joseph Dr
Saint Joseph, MI 49085
Phone (269) 982-4272
1234 Napier Ave
Saint Joseph, MI 49085
Phone (269) 982-4941
3950 Hollywood Rd
Ste 280
Saint Joseph, MI 49085
Phone (269) 408-0990
2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426
1 Medical Park Blvd
Ste 210E
Bristol, TN 37620
Phone (423) 224-4000
1 Medical Park Blvd
Bristol, TN 37620
Phone (423) 390-0451
111 W Stone Dr
Ste 100
Kingsport, TN 37660
Phone (423) 247-5197
130 W Ravine Rd
Kingsport, TN 37660
Phone (423) 224-3150
1802 Braeburn Dr
Salem, VA 24153
Phone (540) 772-3400
Interoperability endpoints
- mark.burson@hca5.eclinicaldirectplus.com
Organizations & group practices 8
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.
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- Internal Medicine Physician
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- NPI 1538397120
-
- Internal Medicine Physician
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- NPI 1902977705
-
- Pulmonary Disease Physician
- Kingsport, TN
- NPI 1780986257
-
- Internal Medicine Physician
- Bridgman, MI
- NPI 1568232247
-
- Psychiatry Physician
- Johnson City, TN
- NPI 1275393522
-
- Specialist
- Stockbridge, GA
- NPI 1669570990
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Macon, GA
- NPI 1598719643
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132012800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1750291200000",
"number": "1104808229",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "330 HOSPITAL DR STE 315",
"city": "MACON",
"state": "GA",
"postal_code": "312178042"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "330 HOSPITAL DR STE 315",
"city": "MACON",
"state": "GA",
"postal_code": "312178042",
"telephone_number": "478-742-5331"
}
],
"practiceLocations": [
{
"address_1": "1802 Braeburn Dr",
"address_purpose": "LOCATION",
"city": "Salem",
"state": "VA",
"postal_code": "241537357",
"country_code": "US",
"telephone_number": "540-772-3702",
"fax_number": "540-772-3703",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "107 Ledford Mill Rd",
"address_purpose": "LOCATION",
"city": "Tullahoma",
"state": "TN",
"postal_code": "373882278",
"country_code": "US",
"telephone_number": "931-454-1955",
"fax_number": "931-454-1956",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1010 Three Springs Blvd Ste 270",
"address_purpose": "LOCATION",
"city": "Durango",
"state": "CO",
"postal_code": "813018296",
"country_code": "US",
"telephone_number": "970-764-3845",
"fax_number": "970-764-3823",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BURSON",
"first_name": "MARK",
"middle_name": "LLOYD",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-11-15",
"last_updated": "2025-06-19",
"certification_date": "2025-06-19",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "VA",
"license": "0101265824",
"primary": false
},
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "CO",
"license": "CDR.0004667",
"primary": false
},
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "TN",
"license": "40439",
"primary": false
},
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "GA",
"license": "36112",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "4116328",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Macon, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2025; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.