Samuel William Burwell III

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

Practice address

1945 Laveer St
Philadelphia, PA 19141-1403

Phone

(267) 591-0144

NPI assigned

Jul 16, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1563235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563235200000",
    "number": "1659923936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1945 LAVEER ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191411403",
            "telephone_number": "267-591-0144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1945 LAVEER ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191411403",
            "telephone_number": "267-591-0144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURWELL",
        "first_name": "SAMUEL",
        "middle_name": "WILLIAM",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-07-16",
        "last_updated": "2019-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "VA.GOV",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1945 Laveer St",
            "city": "Philadelphia",
            "state": "PA",
            "country_code": "US",
            "postal_code": "191411403",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kristen Kelly Burton, MD
• Leslie Burton, CRNP
• Raekwon Burton, MSW, LSW
• Ronika Elise Burton, LCSW
• Vincent Burton
• Alexa Rose Burychka, PA-C
• Jacqueline Marie Buscarini, OTR
• Kelsey Jurist Busch, PT, DPT
• Victoria Lesley Ann Busch
• Ashleigh N Bush, MD

• Athletic Trainer in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Athletic Trainer in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.