Active NPI
Richard Gerald Burris, M.D.
- Family Medicine Physician
- Monticello, MS
National Provider Identifier
1487652228
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 06985
- Practice address
- 827 F E Sellers Hwy
Monticello, MS 39654-9378 - Phone
- (601) 587-4648
- Fax
- (601) 587-0613
- NPI assigned
- Jul 13, 2005
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 06985 | MS | Primary |
Addresses
Primary practice location
827 F E Sellers Hwy
Monticello, MS 39654-9378
Mailing address
PO Box 728
Monticello, MS 39654-0728
Phone (601) 587-4648
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00015262 | Medicaid | MS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MS
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100331000106 | MS | Practitioner - Family Practice | 2961538798 | Practice locations: Monticello, MS |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 06985 | MS | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121212800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1487652228",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 728",
"city": "MONTICELLO",
"state": "MS",
"postal_code": "396540728",
"telephone_number": "601-587-4648",
"fax_number": "601-587-0613"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "827 F E SELLERS HWY",
"city": "MONTICELLO",
"state": "MS",
"postal_code": "396549378",
"telephone_number": "601-587-4648",
"fax_number": "601-587-0613"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURRIS",
"first_name": "RICHARD",
"middle_name": "GERALD",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-07-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MS",
"license": "06985",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00015262",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Monticello, MS
- Brenco
- Bridges Professional Counseling and Consulting LLC
- Kelly Mackenzie Brister, COTA
- Amy Eaton Broome, PTA
- Rebecca Hussey Burris, C.F.N.P.
- Caring Hands Behavioral Health and Wellness LLC
- Caring Hands Children's Clinic, LLC
- Caring Hands Family Practice, LLC
- Robin Catchings, WHNP
- Nicollette Shautria Clark
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.