Individual provider Active NPI

Benjamin Ross Burkett, M.D.

  • Internal Medicine Physician
  • Jackson, MS
National Provider Identifier
1538322052
Registry record updated Jun 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
T-2075 Issued in MS
Practice address
2500 N State St
Jackson, MS 39216-4500
Phone
(601) 984-5200
NPI assigned
Jul 3, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X T-2075 MS Primary
Pediatrics Physician 208000000X T-2075 MS

Addresses

Primary practice location

2500 N State St
Jackson, MS 39216-4500

Mailing address

5001 Hardy St
Hattiesburg, MS 39402-1308
Phone (601) 268-8549

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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

Enrollment IDStateProvider typePAC IDDetails
I20211006000440 AL Practitioner - Internal Medicine 3971750001 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Mississippi School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Montgomery Family Medicine, PCGroup PAC ID 1951361344, 6 clinicians

Practice addresses (Care Compare)

8190 Seaton PL
Montgomery, AL 36116-7204
Phone (334) 396-9100

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
T-2075MSMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Montgomery Family Medicine, PC CurrentSince Sep 15, 2022 Accepting new patients
Hospital Physician Services - Southeast Professional Corporation CurrentSince Sep 1, 2021 Accepting new patients
Montgomery Family Medicine P.C. PastSince Sep 15, 2022 Accepting new patients

Locations

400 Taylor Rd
Montgomery, AL 36117
Phone (334) 213-6287

8190 Seaton Pl
Montgomery, AL 36116
Phone (334) 396-9100

124 S Memorial Dr
Prattville, AL 36067
Phone (334) 361-4267

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HIBDBA

Organizations & group practices 3

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 4

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": "1215043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338508800000",
    "number": "1538322052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5001 HARDY ST",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394021308",
            "telephone_number": "601-268-8549",
            "fax_number": "601-268-8502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 N STATE ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "601-984-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURKETT",
        "first_name": "BENJAMIN",
        "middle_name": "ROSS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-03",
        "last_updated": "2012-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "T-2075",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MS",
            "license": "T-2075",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.