Kevin Todd Burgess

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601004844 Issued in MI

Practice address

1 William Carls Dr
Commerce Township, MI 48382-2201

Phone

(248) 937-3300

NPI assigned

Jan 31, 2013

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

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: kburgess@direct.dmc.org

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

{
    "created_epoch": "1359590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359590400000",
    "number": "1326387093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 WILLIAM CARLS DR",
            "city": "COMMERCE TOWNSHIP",
            "state": "MI",
            "postal_code": "483822201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 WILLIAM CARLS DR",
            "city": "COMMERCE TOWNSHIP",
            "state": "MI",
            "postal_code": "483822201",
            "telephone_number": "248-937-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURGESS",
        "first_name": "KEVIN",
        "middle_name": "TODD",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-01-31",
        "last_updated": "2013-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601004844",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rayna Bryant
• Jennifer Bryce, PA-C
• Mikayla Buglione, DPT
• Jonalyn Damaso Bujaue, PT
• Jennifer Marie Burgess, D.O.
• Brian William Burkardt, DPM
• Jenny Albrough Burley, DPT
• Sheri Diane Calleja, D.D.S.
• Camille Y Humes, LLC
• Marisa Cannon, LMSW

• Physician Assistant in Commerce Township, MI
• Providers in Commerce Township, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 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.