Individual provider Active NPI

Ted H Burningham, MD

  • Family Medicine Physician
  • Worthington, MN
National Provider Identifier
1174509129
Registry record updated Sep 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2758781205 Issued in UT
Practice address
1216 Ryans Rd
Worthington, MN 56187-1722
Phone
(507) 372-2921
Fax
(507) 372-6435
NPI assigned
Dec 21, 2005
Last updated
Sep 22, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2758781205 UT Primary

Addresses

Primary practice location

1216 Ryans Rd
Worthington, MN 56187-1722

Mailing address

1216 Ryans Rd
Worthington, MN 56187-1722
Phone (507) 372-2921

Other identifiers 1

IdentifierTypeStateIssuer
D0819MedicaidUT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, MN, WI3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20051102001218 UT Practitioner - Emergency MedicinePractitioner - Family Practice 4183642754 Reassigns benefits to 1 organization
I20141009001582 MN Practitioner - Family PracticePractitioner - Emergency Medicine 4183642754 Reassigns benefits to 3 organizations
I20251112000991 WI Practitioner - Family Practice 4183642754 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Emergency Medicine
Education
George Washington University School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rural Health Care IncGroup PAC ID 3476447541, shared by 13 NPIs, 156 clinicians

Practice addresses (Care Compare)

1216 Ryans Rd
Worthington, MN 56187-1781
Phone (507) 372-6522

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2758781205UTMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Luke's Hospital of Duluth CurrentSince Oct 1, 2025 Accepting new patients
County of Meeker CurrentSince Dec 1, 2018 Accepting new patients
St. Luke's Hospital of Duluth CurrentSince Oct 1, 2025 Accepting new patients
West Emergency Services, LLC CurrentSince Mar 1, 2022 Accepting new patients
County of Meeker CurrentSince Dec 1, 2018 Accepting new patients
Lifecare Medical Center Current Accepting new patients
St. Luke's Hospital of Duluth Current Accepting new patients
St. Luke's Hospital of Duluth CurrentSince Oct 1, 2025 Accepting new patients
St. Luke's Hospital of Duluth Current Accepting new patients
Tooele Hospital Corporation Past Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

1015 E 1st St
Duluth, MN 55805
Phone (218) 249-7860

612 S Sibley Ave
Litchfield, MN 55355
Phone (320) 693-3242

300 N Hospital Dr
Price, UT 84501
Phone (435) 636-4836

1615 Maple Ln
Ashland, WI 54806
Phone (715) 682-4563

2201 Lake Shore Dr E
Ashland, WI 54806
Phone (715) 685-6600

Organizations & group practices 10

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": "1135123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790035200000",
    "number": "1174509129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1216 RYANS RD",
            "city": "WORTHINGTON",
            "state": "MN",
            "postal_code": "561871722",
            "telephone_number": "507-372-2921",
            "fax_number": "507-372-6435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1216 RYANS RD",
            "city": "WORTHINGTON",
            "state": "MN",
            "postal_code": "561871722",
            "telephone_number": "507-372-2921",
            "fax_number": "507-372-6435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURNINGHAM",
        "first_name": "TED",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-21",
        "last_updated": "2026-09-22",
        "certification_date": "2026-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "2758781205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D0819",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Worthington, MN

Sources for this page

Verify at the official NPI Registry.