Bob Burris, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Practice address

325 Madison Ave
Wood River, IL 62095-2010

Phone

(618) 251-5202

Fax

(618) 251-5118

NPI assigned

Mar 21, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Midwest Occupational Medicine LTD.

  • Occupational Medicine Physician
  • Wood River, IL
  • NPI 1619051620
  NPD (past)

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487779849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 MADISON AVE",
            "city": "WOOD RIVER",
            "state": "IL",
            "postal_code": "620952010",
            "telephone_number": "618-251-5202",
            "fax_number": "618-251-5118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 MADISON AVE",
            "city": "WOOD RIVER",
            "state": "IL",
            "postal_code": "620952010",
            "telephone_number": "618-251-5202",
            "fax_number": "618-251-5118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURRIS",
        "first_name": "BOB",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Behavioral Health Alternatives, Inc
• Beverly Enterprises - Illinois, Inc.
• Jared Andrew Blaylock, PHARMD
• Bravo Care of Wood River Inc
• Bria of Woodriver LP
• Laura Burton
• Keith N Byler, D. O.
• Caldieraro Family Dentistry, PC
• Camp Drugs, Inc
• Abigail Marie Cantalupo

• All providers in Wood River, IL
• Family Medicine Physician in Illinois

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.