NPIMap

Individual provider Active NPI

Andrew Madison Burt, D.M.D

  • General Practice Dentistry
  • Bowling Green, KY
National Provider Identifier
1104980523
Registry record updated Mar 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7273 Issued in KY
Practice address
546 Park St
Suite 400
Bowling Green, KY 42101-1780
Phone
(270) 781-6161
Fax
(270) 781-6129
NPI assigned
Dec 20, 2006
Last updated
Mar 25, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 25, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 7273 KY
General Practice Dentistry 1223G0001X 7273 KY Primary

Addresses

Primary practice location

546 Park St
Suite 400
Bowling Green, KY 42101-1780

Mailing address

546 Park St
Suite 400
Bowling Green, KY 42101-1780
Phone (270) 781-6161

Other identifiers 1

IdentifierTypeStateIssuer
6007273300MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
7273KYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Bluegrass Oral Health Center PLLC General Practice Past Accepting new patients
Andrew M Burt DMD PSC General Practice Past Accepting new patients

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395705600000",
    "number": "1104980523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "546 PARK ST",
            "address_2": "SUITE 400",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421011780",
            "telephone_number": "270-781-6161",
            "fax_number": "270-781-6129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "546 PARK ST",
            "address_2": "SUITE 400",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421011780",
            "telephone_number": "270-781-6161",
            "fax_number": "270-781-6129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURT",
        "first_name": "ANDREW",
        "middle_name": "MADISON",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-20",
        "last_updated": "2014-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KY",
            "license": "7273",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "7273",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6007273300",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowling Green, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2014; 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.