Fernando Bernard Burroughs, LAT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

330 Issued in AL

Practice address

1201 Coliseum Drive
Tuscaloosa, AL 35487-0001

Phone

(205) 348-3600

NPI assigned

Nov 3, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1635897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635897600000",
    "number": "1174288252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 COLISEUM DRIVE",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354870001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 COLISEUM DRIVE",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354870001",
            "telephone_number": "205-348-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURROUGHS",
        "first_name": "FERNANDO",
        "middle_name": "BERNARD",
        "credential": "LAT, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-11-03",
        "last_updated": "2021-11-03",
        "certification_date": "2021-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "AL",
            "license": "330",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALABAMA LICENSURE",
            "identifier": "330",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOC",
            "identifier": "119702484",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bburroughs@ia.ua.edu",
            "affiliation": "N",
            "endpointDescription": "Work email",
            "address_1": "1201 Coliseum Drive",
            "city": "Tuscaloosa",
            "state": "AL",
            "country_code": "US",
            "postal_code": "354870001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• John E Burkhardt II, PSYD
• Andrea Staffo Burns, LCSW
• William Brooks Burns, MD
• Julia Burris
• Debra Crocker Burroughs, RPH
• Karl Burroughs II, PHARM D
• Tami Ashton Burroughs, CRNP
• Pamela Gann Burrus, PHARM D
• John Christopher Burton, LMSW
• Katina Burton, CRNP

• Athletic Trainer in Tuscaloosa, AL
• Providers in Tuscaloosa, AL by specialty
• Athletic Trainer in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2021; 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.