Individual provider Active NPI

John H Burdakin Jr., M.D.

  • Internal Medicine Physician
  • Cedar Rapids, IA
National Provider Identifier
1447210380
Registry record updated Sep 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
48592 Issued in CO
Practice address
600 7TH St SE
Suite 101
Cedar Rapids, IA 52401-2120
Phone
(319) 558-0322
Fax
(319) 558-0324
NPI assigned
Mar 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 4301042277 MI
Internal Medicine Physician 207R00000X 48592 CO Primary

Addresses

Primary practice location

600 7TH St SE
Suite 101
Cedar Rapids, IA 52401-2120

Mailing address

600 7TH St SE
Suite 101
Cedar Rapids, IA 52401-2120
Phone (319) 558-0322

Other identifiers 2

IdentifierTypeStateIssuer
87989271MedicaidCO
102828505MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
48592COMDInternal Medicine Physician
4301042277MIMDHematology & Oncology Physician

NPI Registry JSON

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472774400000",
    "number": "1447210380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 7TH ST SE",
            "address_2": "SUITE 101",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524012120",
            "telephone_number": "319-558-0322",
            "fax_number": "319-558-0324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 7TH ST SE",
            "address_2": "SUITE 101",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524012120",
            "telephone_number": "319-558-0322",
            "fax_number": "319-558-0324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURDAKIN",
        "first_name": "JOHN",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-24",
        "last_updated": "2016-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "MI",
            "license": "4301042277",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "48592",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "87989271",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102828505",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Rapids, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2016; 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.