Jeremy J Burdge, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

35-042744 Issued in OH

Practice address

3732 Olentangy River Rd
Suite C
Columbus, OH 43214-3449

Phone

(614) 451-0411

Fax

(614) 451-8037

NPI assigned

Dec 1, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1133395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377820800000",
    "number": "1235113408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3732 OLENTANGY RIVER RD",
            "address_2": "SUITE C",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432143449",
            "telephone_number": "614-451-0411",
            "fax_number": "614-451-8037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3732 OLENTANGY RIVER RD",
            "address_2": "SUITE C",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432143449",
            "telephone_number": "614-451-0411",
            "fax_number": "614-451-8037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURDGE",
        "first_name": "JEREMY",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-01",
        "last_updated": "2013-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OH",
            "license": "35-042744",
            "primary": true
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "OH",
            "license": "35.042744",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0553753",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PROVIDER ID",
            "identifier": "000000118889",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Renee Burchett, RN
• Shaun Ian Burchett
• Elsa R Burchfield, APRN-CNP
• Laramie Burden
• Leslie Moriah Burdett, RPH, PHARMD
• Nicole Rae Burdine, LPN
• Wendelin A Burdo Hartman, MD
• Chelsea Jo Burdulis, APRN-CNP
• Matthew James Gerard Burford, M.D.
• Burge Services

• Specialist in Columbus, OH
• Providers in Columbus, OH by specialty
• Specialist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.