Stephen Spencer Burnside, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

AA2876 Issued in AK

Practice address

1818 E Rezanof Dr
Kodiak, AK 99615

Phone

(907) 486-6065

Fax

(907) 486-2248

NPI assigned

Feb 27, 2006

Sex

Male

Sole proprietor

No

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 15, 2013.

{
    "created_epoch": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365984000000",
    "number": "1225004401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1818 E REZANOF DR",
            "city": "KODIAK",
            "state": "AK",
            "postal_code": "99615",
            "telephone_number": "907-486-6065",
            "fax_number": "907-486-2248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1818 E REZANOF DR",
            "city": "KODIAK",
            "state": "AK",
            "postal_code": "99615",
            "telephone_number": "907-486-6065",
            "fax_number": "907-486-2248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURNSIDE",
        "first_name": "STEPHEN",
        "middle_name": "SPENCER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-27",
        "last_updated": "2013-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AK",
            "license": "AA2876",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPLOYEE ID",
            "identifier": "920088665",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0173",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MD 03803",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jonathan Brubaker
• Katherine Buchinger, M. ED.
• Paige Buer, PA-C
• Suzanne Marie Buie, DPT
• Christopher Edwin Burnside
• Carolyn D Bustillos
• Amy Butts, RN, BSN
• Kristy A Campbell
• Carrie Randolph D.D.S. Inc.
• Scott Allen Carver, CRNA

• All providers in Kodiak, AK
• Internal Medicine Physician in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.