NPIMap

Organization Active NPI

Gerald C Burnett MD LTD

  • Dermatology Physician
  • South Boston, VA
National Provider Identifier
1104877679
Registry record updated Apr 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
0101017885 Issued in VA
Legal business name
GERALD C BURNETT MD LTD
Practice address
405 Oak Lane
South Boston, VA 24592-0835
Phone
(434) 572-6780
Fax
(434) 572-6033
NPI assigned
May 12, 2006
Last updated
Apr 24, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2008

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

Authorized official

Name
Dr. Gerald Crain Burnett Sr., MDNPI 1205015229
Title
President
Phone
(434) 572-6780

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207N00000X 0101017885 VA Primary

Addresses

Primary practice location

405 Oak Lane
South Boston, VA 24592-0835

Mailing address

405 Oak Lane
PO Box 835
South Boston, VA 24592-0835
Phone (434) 572-6780

National Provider Directory

National Provider Directory

Locations

405 Oak Ln
#835
South Boston, VA 24592
Phone (434) 572-6780

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208995200000",
    "number": "1104877679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 OAK LANE",
            "address_2": "PO BOX 835",
            "city": "SOUTH BOSTON",
            "state": "VA",
            "postal_code": "245920835",
            "telephone_number": "434-572-6780",
            "fax_number": "434-572-6033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 OAK LANE",
            "city": "SOUTH BOSTON",
            "state": "VA",
            "postal_code": "245920835",
            "telephone_number": "434-572-6780",
            "fax_number": "434-572-6033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GERALD C BURNETT MD LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-12",
        "last_updated": "2008-04-24",
        "status": "A",
        "authorized_official_last_name": "BURNETT",
        "authorized_official_first_name": "GERALD",
        "authorized_official_middle_name": "CRAIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "434-572-6780",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": "VA",
            "license": "0101017885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Boston, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2008; 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.