Active NPI
Randy Burris
- Medical-Surgical Registered Nurse
- Norwood, NC
National Provider Identifier
1649527706
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical-Surgical Registered Nurse
- License
- 216642
- Practice address
- 139 Lake Head Rd
Norwood, NC 28128-7607 - Phone
- (336) 391-5874
- NPI assigned
- Aug 8, 2012
- Last updated
- Aug 8, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical-Surgical Registered Nurse | 163WM0705X | 216642 | NC | Primary |
| Ambulatory Care Registered Nurse | 163WP2201X | RN2275155 | MA |
Addresses
Primary practice location
139 Lake Head Rd
Norwood, NC 28128-7607
Mailing address
139 Lake Head Rd
Norwood, NC 28128-7607
Phone (336) 391-5874
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 216642 | NC | MD | Medical-Surgical Registered Nurse |
| RN2275155 | MA | MD | Ambulatory Care Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1344384000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1344384000000",
"number": "1649527706",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "139 LAKE HEAD RD",
"city": "NORWOOD",
"state": "NC",
"postal_code": "281287607",
"telephone_number": "336-391-5874"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "139 LAKE HEAD RD",
"city": "NORWOOD",
"state": "NC",
"postal_code": "281287607",
"telephone_number": "336-391-5874"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURRIS",
"first_name": "RANDY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-08-08",
"last_updated": "2012-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "163WM0705X",
"taxonomy_group": "",
"desc": "Registered Nurse, Medical-Surgical",
"state": "NC",
"license": "216642",
"primary": true
},
{
"code": "163WP2201X",
"taxonomy_group": "",
"desc": "Registered Nurse, Ambulatory Care",
"state": "MA",
"license": "RN2275155",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Norwood, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.