NPIMap

Individual provider Active NPI

Ronnie Boy Burns, DO

  • Psychiatry Physician
  • Duluth, MN
National Provider Identifier
1629027222
Registry record updated Sep 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
43247 Issued in MN
Practice address
502 E 2ND St
Duluth, MN 55805-1913
Phone
(218) 786-8364
NPI assigned
May 9, 2006
Last updated
Sep 22, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 6685 AK
Psychiatry Physician 2084P0800X 43247 MN Primary
Child & Adolescent Psychiatry Physician 2084P0804X 6685 AK

Addresses

Primary practice location

502 E 2ND St
Duluth, MN 55805-1913

Mailing address

400 E 3Rd St
Duluth, MN 55805-1951
Phone (218) 786-8364

Other identifiers 2

IdentifierTypeStateIssuer
1574188MedicaidAK
679442400MedicaidMN

Other names 1

  • Ronald R Solberg Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110818000830 AK Practitioner - Psychiatry 0648293894 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Health and Services - WashingtonGroup PAC ID 8628965910, 47 clinicians

Practice addresses (Care Compare)

2250 S Woodworth Loop
Suite 202
Palmer, AK 99645-7457
Phone (907) 761-5800

3340 Providence Dr
A565
Anchorage, AK 99508-4691
Phone (907) 212-2321

3760 Piper St
Suite 1108a
Anchorage, AK 99508-4683
Phone (907) 212-6900

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
43247MNMDPsychiatry Physician
6685AKMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Washington Current Accepting new patients
City of Valdez CurrentSince Dec 27, 2023 Accepting new patients
Providence Health & Services Washington Psychiatry CurrentSince Sep 1, 2018 Accepting new patients
Providence Health & Services - Washington CurrentSince Jan 20, 2017 Accepting new patients
Providence Health & Services Washington CurrentSince Jan 20, 2017 Accepting new patients
City of Valdez CurrentSince Sep 27, 2018 Accepting new patients
Nystrom & Associates, LTD Past Accepting new patients

Locations

1818 E Rezanof Dr
Kodiak, AK 99615
Phone (907) 481-2400

1915 E Rezanof Dr
Kodiak, AK 99615
Phone (907) 486-3281

911 Meals Ave
Valdez, AK 99686
Phone (907) 835-2249

Interoperability endpoints

  • Direct secure messaging: rburns15619@skagit.direct-ci.com
  • Direct secure messaging: rsolberg88250@ak.providencedirect.org

Organizations & group practices 9

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 1

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": "1147132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695340800000",
    "number": "1629027222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E 3RD ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051951",
            "telephone_number": "218-786-8364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 E 2ND ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051913",
            "telephone_number": "218-786-8364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURNS",
        "first_name": "RONNIE",
        "middle_name": "BOY",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-09",
        "last_updated": "2023-09-22",
        "certification_date": "2023-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AK",
            "license": "6685",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MN",
            "license": "43247",
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "AK",
            "license": "6685",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1574188",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "679442400",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RONALD",
            "last_name": "SOLBERG",
            "middle_name": "R",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Duluth, MN

Sources for this page

Verify at the official NPI Registry.