NPIMap

Individual provider Active NPI

Jason Odell Burnette, M.D.

  • Urology Physician
  • Thomasville, GA
National Provider Identifier
1467614149
Registry record updated Aug 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
069097 Issued in GA
Practice address
100 Mimosa Dr
Thomasville, GA 31792-6676
Phone
(229) 228-5500
NPI assigned
Jun 25, 2008
Last updated
Aug 3, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 003111 GA
Urology Physician 208800000X 069097 GA Primary

Addresses

Primary practice location

100 Mimosa Dr
Thomasville, GA 31792-6676

Mailing address

900 Cairo Rd
Thomasville, GA 31792-4255

Other practice location 1

1120 15th St
Augusta, GA 30912-0004
Phone (706) 721-2519

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jason.burnette.p29@direct.archbold.nextgenshare.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20130709000740 GA Practitioner - Urology 2668619305 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Medical College of Georgia School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Archbold Medical Group, Inc.Group PAC ID 8123196383, 80 clinicians

Practice addresses (Care Compare)

100 Mimosa Dr
Thomasville, GA 31792-6676
Phone (229) 228-5500

1309 W Screven St
Quitman, GA 31643-1819
Phone (229) 263-7868

915 Gordon Ave
Thomasville, GA 31792-6614
Phone (229) 228-2000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection18

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
069097GAMDUrology Physician
003111GAMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Urology Specialists of Georgia Urology CurrentSince Aug 5, 2013 Accepting new patients
Archbold Medical Group, Inc. CurrentSince Oct 1, 2017 Accepting new patients
Archbold Medical Group, Inc. CurrentSince Oct 1, 2017 Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients
Gastroenterology Associates of Central Ga, LLC Past Accepting new patients
Hospital Authority of Mitchell County PastSince Mar 1, 2025 Accepting new patients

Locations

5400 Bowman Rd
#100
Macon, GA 31210
Phone (478) 745-6576

5400 Bowman Rd
Ste 100
Macon, GA 31210
Phone (478) 745-6576

606 W Screven St
Quitman, GA 31643
Phone (229) 228-5500

100 Mimosa Dr
Thomasville, GA 31792
Phone (229) 226-9141

116 Mimosa Dr
Ste 2
Thomasville, GA 31792
Phone (229) 228-5500

900 Cairo Rd
Thomasville, GA 31792
Phone (229) 227-5102

Interoperability endpoints

  • Direct secure messaging: jason.burnette.p29@direct.archbold.nextgenshare.com

Ownership & related parties

All facility ownership & control disclosures 15

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Archbold Brooks SwingbedQuitman, GA, CCN 11Z332 Hospital Corporate Director Mar 1, 2025
Archbold GradyCairo, GA, CCN 110121 Hospital Corporate Director Mar 1, 2025
Archbold Grady SwingbedCairo, GA, CCN 11U121 Hospital Corporate Director Mar 1, 2025
Archbold MitchellCamilla, GA, CCN 111331 Hospital Corporate Director Mar 1, 2025
Archbold Mitchell SwingbedCamilla, GA, CCN 11Z331 Hospital Corporate Director Mar 1, 2025
Archbold MemorialThomasville, GA, CCN 110038 Hospital Corporate Director Mar 1, 2025
Archbold NorthsideThomasville, GA, CCN 11S038 Hospital Corporate Director Mar 1, 2025
Archbold Memorial RehabThomasville, GA, CCN 11T038 Hospital Corporate Director Mar 1, 2025
Archbold BrooksQuitman, GA, CCN 111332 Hospital Corporate Director Mar 1, 2025
Mitchell County Nursing HomesCamilla, GA, CCN 115266 Skilled nursing facility Corporate Officer Mar 1, 2025
Archbold Living ThomasvilleThomasville, GA, CCN 115480 Skilled nursing facility Corporate Officer Mar 1, 2025
Archbold Living CairoCairo, GA, CCN 115776 Skilled nursing facility Corporate Director Mar 1, 2025
Archbold Pediatrics CamillaCamilla, GA, CCN 113474 Rural health clinic Corporate Director Mar 1, 2025
Archbold Primary Care CamillaCamilla, GA, CCN 118519 Rural health clinic Corporate Director Mar 1, 2025
Archbold Primary Care PelhamPelham, GA, CCN 118544 Rural health clinic Corporate Director Mar 1, 2025

Owned or controlled facilities with NPI records 18

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

View all 18

Organizations & group practices 6

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 7

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": "1214352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596412800000",
    "number": "1467614149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 CAIRO RD",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317924255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MIMOSA DR",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317926676",
            "telephone_number": "229-228-5500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1120 15th St",
            "address_purpose": "LOCATION",
            "city": "Augusta",
            "state": "GA",
            "postal_code": "309120004",
            "country_code": "US",
            "telephone_number": "706-721-2519",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURNETTE",
        "first_name": "JASON",
        "middle_name": "ODELL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-25",
        "last_updated": "2020-08-03",
        "certification_date": "2020-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "GA",
            "license": "003111",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "GA",
            "license": "069097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jason.burnette.p29@direct.archbold.nextgenshare.com",
            "affiliation": "N",
            "address_1": "100 Mimosa Dr",
            "city": "Thomasville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "317926676",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Thomasville, GA

Sources for this page

Verify at the official NPI Registry.