Everett Carl Burgess Jr., M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

35040675 Issued in OH

Practice address

75 Arch St Ste 301
Akron, OH 44304-1429

Phone

(330) 762-8875

Fax

(330) 762-2165

NPI assigned

Aug 31, 2006

Last updated

Feb 24, 2009By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235433600000",
    "number": "1437261039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2937 IVANHOE RD",
            "city": "SILVER LAKE",
            "state": "OH",
            "postal_code": "442243011",
            "telephone_number": "330-923-4118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 ARCH ST STE 301",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443041429",
            "telephone_number": "330-762-8875",
            "fax_number": "330-762-2165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURGESS",
        "first_name": "EVERETT",
        "middle_name": "CARL",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2009-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OH",
            "license": "35040675",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0343891",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Burdyny
• Bureau of Long-Term Care Services and Supports
• Kelly E Burgan, LPN
• Debra Kay Burgess
• Dorothy Burgess, CDCA
• Kianna Burgins, LPN
• Latroya Ja'Quex Burgins
• Sabrina Burgio
• Christian Burgsos, RBT
• Tammy Marie Burkart, RPH

• Specialist in Akron, OH
• Providers in Akron, OH by specialty
• Specialist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.