Individual provider Active NPI

Virginia Deann Burnett, D.O.

  • Obstetrics & Gynecology Physician
  • Las Cruces, NM
National Provider Identifier
1194931352
Registry record updated Feb 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
A-1750-13 Issued in NM
Practice address
4345 Senna Dr
Las Cruces, NM 88011
Phone
(575) 636-8854
NPI assigned
May 15, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X A-1750-13 NM Primary

Addresses

Primary practice location

4345 Senna Dr
Las Cruces, NM 88011

Mailing address

1300G El Paseo Rd # 308
Las Cruces, NM 88001-6024
Phone (575) 636-8854

Other identifiers 2

IdentifierTypeStateIssuer
38607051MedicaidNM
312538YRNDOtherNMMEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM, TX2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20131008000353 NM Practitioner - Obstetrics/Gynecology 6608964895 Reassigns benefits to 1 organization
I20210518000580 TX Practitioner - Obstetrics/Gynecology 6608964895 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
A-1750-13NMMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Obhg Texas Holdings, P.a. Obstetrics & Gynecology CurrentSince Apr 16, 2021 Accepting new patients
Las Cruces Physician Practices, LLC CurrentSince May 20, 2014 Accepting new patients
Las Cruces Physician Practices, LLC Current Accepting new patients
El Paso Healthcare System LTD Past Accepting new patients

Locations

4351 E Lohman Ave
Ste 403
Las Cruces, NM 88011
Phone (575) 522-6806

777 Lowndes Hill Rd
Bldg 1
Greenville, SC 29607
Phone (864) 908-3736

5950 Saratoga Blvd
Corpus Christi, TX 78414
Phone (321) 917-9263

Organizations & group practices 4

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": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612137600000",
    "number": "1194931352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300G EL PASEO RD # 308",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880016024",
            "telephone_number": "575-636-8854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4345 SENNA DR",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "88011",
            "telephone_number": "575-636-8854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURNETT",
        "first_name": "VIRGINIA",
        "middle_name": "DEANN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-15",
        "last_updated": "2021-02-01",
        "certification_date": "2021-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NM",
            "license": "A-1750-13",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38607051",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "312538YRND",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Cruces, NM

Sources for this page

Verify at the official NPI Registry.