Individual provider Active NPI

Eileen Mary Burchby, MD

  • Addiction Medicine (Preventive Medicine) Physician
  • Bradenton, FL
National Provider Identifier
1407808744
Registry record updated Sep 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Preventive Medicine) PhysicianTaxonomy code 2083A0300X
License
ME148372 Issued in FL
Practice address
201 4TH Ave E Ste 2
Bradenton, FL 34208-1043
Phone
(941) 226-0018
Fax
(941) 260-4872
NPI assigned
May 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Preventive Medicine) Physician 2083A0300X ME148372 FL Primary
Pediatrics Physician 208000000X 38674 MN
Addiction Medicine (Preventive Medicine) Physician 2083A0300X 148372 FL

Addresses

Primary practice location

201 4TH Ave E Ste 2
Bradenton, FL 34208-1043

Mailing address

4912 20TH Ave W
Bradenton, FL 34209-5702
Phone (516) 233-8034

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20211118003123 FL Practitioner - Addiction Medicine 3577465889 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Addiction Medicine
Education
University of Minnesota Medical School, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Recover Together IncGroup PAC ID 7810247533, 141 clinicians

Practice addresses (Care Compare)

2020 Kingsley Ave
Suite 3
Orange Park, FL 32073-5181
Phone (800) 683-8313

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
148372FLMDAddiction Medicine (Preventive Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Recover Together, Inc. CurrentSince Sep 1, 2023 Accepting new patients
Centerstone of Florida, Inc. CurrentSince Oct 2, 2023 Accepting new patients
Centerstone of Florida, Inc. PastSince Jul 4, 2021 Accepting new patients
Lightshare Behavioral Wellness and Recovery PastSince Jul 4, 2021 Accepting new patients

Locations

2020 26th Ave E
Bradenton, FL 34208
Phone (941) 782-4600

2216 Highway 44 W
Inverness, FL 34453
Phone (352) 341-0009

3233 SW 33rd Rd
Ste 202
Ocala, FL 34474
Phone (352) 433-2883

111 S Bedford St
Ste 205
Burlington, MA 01803
Phone (512) 439-3547

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725580800000",
    "number": "1407808744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4912 20TH AVE W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342095702",
            "telephone_number": "516-233-8034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 4TH AVE E STE 2",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342081043",
            "telephone_number": "941-226-0018",
            "fax_number": "941-260-4872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURCHBY",
        "first_name": "EILEEN",
        "middle_name": "MARY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-16",
        "last_updated": "2024-09-06",
        "certification_date": "2024-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083A0300X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Addiction Medicine",
            "state": "FL",
            "license": "ME148372",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "38674",
            "primary": false
        },
        {
            "code": "2083A0300X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Addiction Medicine",
            "state": "FL",
            "license": "148372",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

Verify at the official NPI Registry.