Corey C. Burgoyne, DMD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

0401410961 Issued in VA

Practice address

54 S Medical Park Dr
Fishersville, VA 22939-2333

Phone

(540) 886-2956

Fax

(540) 213-8748

NPI assigned

May 17, 2007

Last updated

Apr 20, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Oral SurgeryAlso: Maxillofacial Surgery

Education

Medical Univ of South Carolina Col of Dental Med, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Blue Ridge Oral Surgery, Inc.Group PAC ID 5496827834, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Blue Ridge Oral Surgery, Inc.

  dba Blue Ridge Oral & Maxillofacial Surgery

  • Oral and Maxillofacial Surgery (Dentist)
  • Fishersville, VA
  • NPI 1710013446
  Medicare reassignment Care Compare group NPD
• Commonwealth Oral & Facial Surgery, PC

  • Oral and Maxillofacial Surgery (Dentist)
  • Richmond, VA
  • NPI 1144274382
  NPD (past)

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587340800000",
    "number": "1518174614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54 S MEDICAL PARK DR",
            "city": "FISHERSVILLE",
            "state": "VA",
            "postal_code": "229392333",
            "telephone_number": "540-886-2956",
            "fax_number": "540-213-8748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "54 S MEDICAL PARK DR",
            "city": "FISHERSVILLE",
            "state": "VA",
            "postal_code": "229392333",
            "telephone_number": "540-886-2956",
            "fax_number": "540-213-8748"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "112 Houston St Ste B",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "VA",
            "postal_code": "244502451",
            "country_code": "US",
            "telephone_number": "540-886-2956",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURGOYNE",
        "first_name": "COREY",
        "middle_name": "C.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-17",
        "last_updated": "2020-04-20",
        "certification_date": "2020-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "VA",
            "license": "0401410961",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "VA",
            "license": "0401410961",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kay A Buchanan, O.T.
• Janet Buchheit
• Carie Daniel Buckley III, MD
• Christopher Thomas Bunn, D.O.
• David A Burgess, M.D.
• Robert W Burke, PA-C
• Jamie Burkholder
• Kelli Burnett, PA
• Pamela Wampler Butler, RPT
• Janice Koontz Callender, RD

• Oral and Maxillofacial Surgery (Dentist) in Fishersville, VA
• Providers in Fishersville, VA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.