Individual provider Active NPI

James Benjiman Burdette III, PA-C

  • Medical Physician Assistant
  • Southfield, MI
National Provider Identifier
1235366162
Registry record updated Oct 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
5601002272 Issued in MI
Practice address
23999 Northwestern Hwy
Suite # 110
Southfield, MI 48075-2578
Phone
(248) 223-1500
Fax
(248) 223-9600
NPI assigned
Jun 18, 2009
Last updated
Oct 15, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 5601002272 MI Primary

Addresses

Primary practice location

23999 Northwestern Hwy
Suite # 110
Southfield, MI 48075-2578

Mailing address

23999 Northwestern Hwy Ste 110
Southfield, MI 48075-2578
Phone (248) 223-1500

Other practice location 1

18000 W 9 Mile Rd Ste 525
Southfield, MI 48075-4080
Phone (248) 327-6196

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5601002272MIMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Kamitko Coleman Past Accepting new patients
United Medical Clinic PastSince Nov 1, 2013 Accepting new patients
Healthland P C PastSince Mar 21, 2020 Accepting new patients
Traveling Physician Services PC Past Accepting new patients
Healthland Housecall Services LLC PastSince Dec 9, 2019 Accepting new patients

Organizations & group practices 5

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": "1245283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792022400000",
    "number": "1235366162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23999 NORTHWESTERN HWY STE 110",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480752578",
            "telephone_number": "248-223-1500",
            "fax_number": "248-223-9600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23999 NORTHWESTERN HWY",
            "address_2": "SUITE # 110",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480752578",
            "telephone_number": "248-223-1500",
            "fax_number": "248-223-9600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18000 W 9 Mile Rd Ste 525",
            "address_purpose": "LOCATION",
            "city": "Southfield",
            "state": "MI",
            "postal_code": "480754080",
            "country_code": "US",
            "telephone_number": "248-327-6196",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURDETTE",
        "first_name": "JAMES",
        "middle_name": "BENJIMAN",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-18",
        "last_updated": "2026-10-15",
        "certification_date": "2026-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601002272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.