NPIMap

Individual provider Active NPI

Julie Anne-Marie Burnham, D.O.

  • Neurology Physician
  • Mount Clemens, MI
National Provider Identifier
1336246966
Registry record updated Jul 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
JH012296 Issued in MI
Practice address
1030 Harrington St
Mount Clemens, MI 48043-2967
Phone
(586) 493-3188
Fax
(586) 493-3191
NPI assigned
Sep 17, 2006
Last updated
Jul 26, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 26, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X JH012296 MI Primary

Addresses

Primary practice location

1030 Harrington St
Mount Clemens, MI 48043-2967

Mailing address

1030 Harrington St
Ste 205
Mount Clemens, MI 48043-2967
Phone (586) 493-3188

Other names 1

  • Dr. Julie Burnham Hice Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031219000769 MI Practitioner - Neurology 9335047919 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Wayne State University School of Medicine, 1994
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1030 Harrington St
Mount Clemens, MI 48043-2918

1030 Harrington St
Suite 205
Mount Clemens, MI 48043-2967
Phone (586) 493-3195

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
JH012296MIMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Michigan Neurology, P.L.L.C. CurrentSince Jan 1, 2003 Accepting new patients

Locations

1030 Harrington St
Mount Clemens, MI 48043
Phone (586) 493-3195

1030 Harrington St
Ste 205
Mount Clemens, MI 48043
Phone (586) 493-3195

Organizations & group practices 1

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.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1158451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532563200000",
    "number": "1336246966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 HARRINGTON ST",
            "address_2": "STE 205",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "480432967",
            "telephone_number": "586-493-3188",
            "fax_number": "586-493-3191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 HARRINGTON ST",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "480432967",
            "telephone_number": "586-493-3188",
            "fax_number": "586-493-3191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURNHAM",
        "first_name": "JULIE",
        "middle_name": "ANNE-MARIE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-17",
        "last_updated": "2018-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MI",
            "license": "JH012296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JULIE",
            "last_name": "HICE",
            "middle_name": "BURNHAM",
            "prefix": "DR.",
            "credential": "D.O.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Mount Clemens, MI

Sources for this page

Verify at the official NPI Registry.