Organization Active NPI

Charles J. Burch, M.D., P.a.

  • Pulmonary Disease Physician
  • San Antonio, TX
National Provider Identifier
1588843239
Registry record updated Feb 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
K2657 Issued in TX
Legal business name
CHARLES J. BURCH, M.D., P.A.
Practice address
4458 Medical Dr Ste 505
San Antonio, TX 78229-3748
Phone
(210) 690-7400
Fax
(210) 690-7405
NPI assigned
Oct 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2022

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

Authorized official

Name
Charles J Burch, MDNPI 1831196559
Title
MD/Owner
Phone
(210) 690-7400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RP1001X K2657 TX Primary

Addresses

Primary practice location

4458 Medical Dr Ste 505
San Antonio, TX 78229-3748

Mailing address

4458 Medical Dr Ste 505
San Antonio, TX 78229-3748
Phone (210) 690-7400

Other identifiers 1

IdentifierTypeStateIssuer
160409201MedicaidTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040316000144 TX Part B Supplier - Clinic/Group Practice 4688564602 Receives reassigned benefits from 4 practitioners
Practice locations: Boerne, TX; San Antonio, TX

National Provider Directory

National Provider Directory

Locations

21 Spurs Ln
Ste 230B
San Antonio, TX 78240

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1193702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644451200000",
    "number": "1588843239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4458 MEDICAL DR STE 505",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293748",
            "telephone_number": "210-690-7400",
            "fax_number": "210-690-7405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4458 MEDICAL DR STE 505",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293748",
            "telephone_number": "210-690-7400",
            "fax_number": "210-690-7405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES J. BURCH, M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-30",
        "last_updated": "2022-02-10",
        "certification_date": "2022-02-10",
        "status": "A",
        "authorized_official_last_name": "BURCH",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MD/OWNER",
        "authorized_official_telephone_number": "210-690-7400",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "TX",
            "license": "K2657",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "160409201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.