Stanley Wayne Burleson, MD
Individual provider Active NPI Family Medicine Physician · Dewitt, AR
NPI 1295839397 · NPPES record last updated Mar 1, 2024
Key facts
- NPI
- 1295839397
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- C-5377 (AR)
- Practice address
- 705 W 16TH St
Dewitt, AR 72042 - Phone
- (870) 946-1326
- Fax
- (870) 946-4335
- NPI assigned
- Sep 11, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Hospital & facility affiliations 4
Owned or controlled facilities with NPI records 2
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- University of Arkansas College of Medicine, 1978
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Dewitt Hospital and Nursing Home Inc
Practice addresses (Care Compare)
705 W 16TH St
De Witt, AR 72042-3414
Phone (870) 946-3571
Hospital & facility affiliations
- Jefferson Homecare
- Dewitt Hospital & Nursing Home, Inc
- Baptist Health Medical Center-Little Rock
- Baptist Health Medical Center-Stuttgart
- Crestpark Dewitt, LLC
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
| Removal of nail tissue | 1-10 |
| Skin biopsy | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
All facility ownership & control disclosures 3
| Facility | Type | Role | Since |
|---|---|---|---|
| Dewitt Hospital & Nursing Home Inc |
Hospital | Corporate Director | Mar 28, 2002 |
| Dewitt Nursing Home |
Skilled nursing facility | Corporate Director | Mar 28, 2002 |
| Dewitt Hospital & Nursing Home Inc |
Rural health clinic | Corporate Director | Mar 28, 2002 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080623000594 | AR | Practitioner - Family Practice | 4688766181 |
Reassigns benefits to 1 organization Practice locations: Dewitt, AR |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C-5377 | AR | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dewitt Hospital & Nursing Home, Inc. | Current |
Accepting new patients |
Locations
1641 S Whitehead Dr
Dewitt, AR 72042
Phone (870) 946-2971
705 W 16th St
Dewitt, AR 72042
Phone (870) 946-1326
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | C-5377 | AR | Yes |
Addresses
Primary practice location
705 W 16TH St
Dewitt, AR 72042
Mailing address
PO Box 352
Dewitt, AR 72042
Phone (870) 946-1326
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| M038602 | Other | UNITED HEALTHCARE | |
| 102980001 | Medicaid | AR | |
| 14220000000 | Other | PUAL CHOICE |
Other providers in Dewitt, AR
- James Douglas Allen
- Baptist Health Hospitals
- Suzette Nicole Boyd
- Alton Chambless
- Deans Pharmacies, Inc.
- Debra D. Horton
- Dewitt Family Practice
- Easy Living
All providers in Dewitt, AR · Family Medicine Physician in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 1, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.