Carolyn Smith Burwell, MD

Individual provider Active NPI Pediatrics Physician · Norfolk, VA

NPI 1205968666 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1205968666
Entity type
Individual (NPI type 1)
Primary specialty
Pediatrics Physician 208000000X
License
0101030380 (VA)
Practice address
830 Southampton Avenue
Norfolk Dept of Public Health
Norfolk, VA 23510
Phone
(757) 683-8770
Fax
(757) 683-9211
NPI assigned
Mar 12, 2007
Sex
Female
Sole proprietor
No

Organizations & group practices 12

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.

Medicare Care Compare profile

Specialty
Pediatric Medicine
Education
Virginia Commonwealth University, School of Medicine, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Commonwealth of Virginia State Board of Health (13 clinicians)

Practice addresses (Care Compare)

830 Southampton Ave
Suite 200
Norfolk, VA 23510-1045
Phone (757) 683-2807

Medicare participation

Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20110516000000 VA Practitioner - Pediatric Medicine 8729264452 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Commonwealth of Virginia State Board of Health Current
since Feb 28, 2011
Accepting new patients
Commonwealth of Virginia State Board of Health Current
since Feb 28, 2011
Accepting new patients
Norfolk Department of Public Health Past Accepting new patients

Locations

830 Southampton Ave
Ste 200
Norfolk, VA 23510
Phone (757) 683-2796

830 Southampton Ave
Norfolk, VA 23510
Phone (757) 683-2796

109 Governor St
Fl 13
Richmond, VA 23219
Phone (804) 864-7009

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 0101030380 VA Yes

Addresses

Primary practice location

830 Southampton Avenue
Norfolk Dept of Public Health
Norfolk, VA 23510

Mailing address

33266 Edgehill Drive
Franklin, VA 23851
Phone (757) 569-8249

Other providers in Norfolk, VA

All providers in Norfolk, VA · Pediatrics Physician in Virginia

Sources for this page

Verify at the official NPI Registry.