Organization Active NPI

Joseph Burnette, LLC

  • Surgery Physician
  • Macon, GA
National Provider Identifier
1235498833
Registry record updated May 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
033286 Issued in GA
Legal business name
JOSEPH BURNETTE, LLC
Practice address
420 Charter Blvd
Suite 320
Macon, GA 31210-4854
Phone
(478) 330-6755
Fax
(478) 330-6759
NPI assigned
May 16, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2012

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

Authorized official

Name
Joseph J Burnette, MDNPI 1205823911
Title
Owner
Phone
(478) 330-6755

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X 033286 GA Primary

Addresses

Primary practice location

420 Charter Blvd
Suite 320
Macon, GA 31210-4854

Mailing address

420 Charter Blvd
Suite 320
Macon, GA 31210-4854
Phone (478) 330-6755

Other identifiers 1

IdentifierTypeStateIssuer
00430669AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120725000605 GA Part B Supplier - Clinic/Group Practice 1658537287 Receives reassigned benefits from 1 practitioner
Practice locations: Macon, GA

National Provider Directory

National Provider Directory

Locations

420 Charter Blvd
Ste 320
Macon, GA 31210
Phone (478) 330-6755

249 Sheraton Blvd
Macon, GA 31210
Phone (478) 241-2780

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1337126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337126400000",
    "number": "1235498833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 CHARTER BLVD",
            "address_2": "SUITE 320",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312104854",
            "telephone_number": "478-330-6755",
            "fax_number": "478-330-6759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 CHARTER BLVD",
            "address_2": "SUITE 320",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312104854",
            "telephone_number": "478-330-6755",
            "fax_number": "478-330-6759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOSEPH BURNETTE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-16",
        "last_updated": "2012-05-16",
        "status": "A",
        "authorized_official_last_name": "BURNETTE",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "478-330-6755",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "GA",
            "license": "033286",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00430669A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.