Edward Clark Burnside, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

TL 1511 Issued in SC

Practice address

1028 Ewall St
Mt Pleasant, SC 29464-3046

Phone

(843) 573-0499

Fax

(843) 388-6292

NPI assigned

Mar 2, 2010

Last updated

Mar 2, 2010By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Carolina Kidney & Hypertension Center, LLC

  • Nephrology Physician
  • Charleston, SC
  • NPI 1457402182
  Medicare reassignment
• Nra-Mt. Pleasant, South Carolina, LLC

  dba Fresenius Medical Care Mount Pleasant

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Mount Pleasant, SC
  • NPI 1285677963
  NPD (past)

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

{
    "created_epoch": "1267488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267488000000",
    "number": "1639492952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 81113",
            "address_2": "ASHLEY RIVER STATION",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294161113",
            "telephone_number": "843-573-0499",
            "fax_number": "843-388-6298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1028 EWALL ST",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294643046",
            "telephone_number": "843-573-0499",
            "fax_number": "843-388-6292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURNSIDE",
        "first_name": "EDWARD",
        "middle_name": "CLARK",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-03-02",
        "last_updated": "2010-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "SC",
            "license": "TL 1511",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SC STATE TEMP LICENSE",
            "identifier": "TL 1511",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brenda Lee Burkholder, RN
• Kaitlin Murray Burley, PHARMD
• Caroline Amanda Burnett, PHARM.D.
• Holly Elizabeth Burnett
• Kelsey L Burnette, BCABA
• Lisa Buscemi
• Judith Bussie
• Lisa Marie Butcher Glavin, MA, LPC, LPCS
• Daniel R Butler, PA-C
• Rachael Butler, RN

• Medical Physician Assistant in Mount Pleasant, SC
• Providers in Mount Pleasant, SC by specialty
• Medical Physician Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2010; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.