Active NPI
Michael R Burt, MD
- Pediatrics Physician
- Muncie, IN
National Provider Identifier
1447224498
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 01028368
- Practice address
- 205 N Tillotson Ave
Suite
Muncie, IN 47304-3900 - Phone
- (765) 289-2353
- NPI assigned
- Feb 15, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 01028368 | IN | Primary |
Addresses
Primary practice location
205 N Tillotson Ave
Suite
Muncie, IN 47304-3900
Mailing address
205 N Tillotson Ave
Suite
Muncie, IN 47304-3900
Phone (765) 289-2353
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200014320A | Medicaid | IN |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139961600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1364860800000",
"number": "1447224498",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "205 N TILLOTSON AVE",
"address_2": "SUITE",
"city": "MUNCIE",
"state": "IN",
"postal_code": "473043900",
"telephone_number": "765-289-2353"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "205 N TILLOTSON AVE",
"address_2": "SUITE",
"city": "MUNCIE",
"state": "IN",
"postal_code": "473043900",
"telephone_number": "765-289-2353"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURT",
"first_name": "MICHAEL",
"middle_name": "R",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-15",
"last_updated": "2013-04-02",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "IN",
"license": "01028368",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200014320A",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Muncie, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.