Individual provider Active NPI

Burin Nuchniyom, M.D.

  • Internal Medicine Physician
  • Ridgeland, MS
National Provider Identifier
1124075502
Registry record updated Jul 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
C52887 Issued in CA
Practice address
604 Muirwood Cir
Ridgeland, MS 39157-3624
Phone
(601) 668-5850
NPI assigned
May 30, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X C52887 CA Primary
Emergency Medicine Physician 207P00000X 15550 MS

Addresses

Primary practice location

604 Muirwood Cir
Ridgeland, MS 39157-3624

Mailing address

604 Muirwood Cir
Ridgeland, MS 39157-3624
Phone (601) 668-5850

Other identifiers 1

IdentifierTypeStateIssuer
00119043MedicaidMS

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
C52887CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Finest Emergency Physicians Emergency Medicine Past Accepting new patients
Lefleur Emergency Physicians Emergency Medicine Past Accepting new patients
River Oaks Management Company LLC Internal Medicine Past Accepting new patients
Independent Healthcare Management, Inc. Past Accepting new patients
United Emergency Services, Inc. Emergency Medicine Past Accepting new patients

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1148947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311292800000",
    "number": "1124075502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604 MUIRWOOD CIR",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391573624",
            "telephone_number": "601-668-5850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 MUIRWOOD CIR",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391573624",
            "telephone_number": "601-668-5850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUCHNIYOM",
        "first_name": "BURIN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-30",
        "last_updated": "2011-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "C52887",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MS",
            "license": "15550",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00119043",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgeland, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2011; 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.