Jeffrey Mark Burnham, MD

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

License

017109 Issued in LA

Practice address

10310 The Grove Blvd Ste 100
Baton Rouge, LA 70836-6455

Phone

(225) 761-5200

Fax

(225) 761-5702

NPI assigned

Sep 2, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in LA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Ochsner Clinic LLC

  • General Practice Physician
  • New Orleans, LA
  • NPI 1538151428
  Medicare reassignment NPD
• Convenient Care LLC

  • Urgent Care Clinic/Center
  • Baton Rouge, LA
  • NPI 1164422630
  Medicare reassignment
• Convenient Care LLC

  • Urgent Care Clinic/Center
  • Zachary, LA
  • NPI 1205143708
  NPD
• Ochsner Clinic LLC

  • Registered Dietitian
  • Covington, LA
  • NPI 1013747039
  NPD
• Ochsner Clinic LLC

  • General Practice Physician
  • Baton Rouge, LA
  • NPI 1992065122
  NPD
• Baton Rouge General Physicians, Inc.

  • Internal Medicine Physician
  • Baton Rouge, LA
  • NPI 1992729560

  Family Medicine

  NPD (past)

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

{
    "created_epoch": "1125619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617062400000",
    "number": "1295729481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12916 MORGAN MEADOW AVENUE",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "70818",
            "telephone_number": "225-938-9287",
            "fax_number": "225-237-1786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10310 THE GROVE BLVD STE 100",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708366455",
            "telephone_number": "225-761-5200",
            "fax_number": "225-761-5702"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8585 Picardy Ave Ste 318",
            "address_purpose": "LOCATION",
            "city": "Baton Rouge",
            "state": "LA",
            "postal_code": "708093749",
            "country_code": "US",
            "telephone_number": "225-763-4430",
            "fax_number": "225-237-1786",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURNHAM",
        "first_name": "JEFFREY",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-02",
        "last_updated": "2021-03-30",
        "certification_date": "2021-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "LA",
            "license": "017109",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1357502",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080179868",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marie Adele Burkstaller, CRNA
• Debra K Burleigh, LCSW
• Mallory A. Burleigh
• Christopher Burnell
• Darla Michele Rutherford Burnett, PH.D., M.P.
• Jeremy Mark Burnham, M.D.
• Anna Devall Burns, MD
• Anne Burns, M.C.D., CCC-SLP
• Carliesha Burns
• Gabrielle A Burns, MA, CCC-SLP

• Sports Medicine (Family Medicine) Physician in Baton Rouge, LA
• Providers in Baton Rouge, LA by specialty
• Sports Medicine (Family Medicine) Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2021; 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.