Individual provider Active NPI

David Burnette, PA

  • Physician Assistant
  • Huntington, WV
National Provider Identifier
1669410510
Registry record updated Nov 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
00931 Issued in WV
Practice address
2860 3Rd Ave
Suite 230
Huntington, WV 25702-1454
Phone
(304) 525-3711
Fax
(304) 525-2748
NPI assigned
Jun 3, 2006
Last updated
Nov 18, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 00931 WV Primary

Addresses

Primary practice location

2860 3Rd Ave
Suite 230
Huntington, WV 25702-1454

Mailing address

PO Box 88
5 E Alvon Road Suite 7
White Sulphur Springs, WV 24986-2373
Phone (304) 536-5030

Other identifiers 4

IdentifierTypeStateIssuer
3001162OtherWVWORKERS COMPENSATION
P00949891OtherWVRR MEDICARE
001719576OtherWVBLUE CROSS BLUE SHIELD
7100170150MedicaidKY

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)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
931WVMDRegistered Dietitian
00931WVMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St. Mary's Himg, LLC Past Accepting new patients
Ultimate Health Services Inc Past Accepting new patients
River Valley Emergency Physicians, Inc Physician Assistant Past Accepting new patients
St. Mary's Medical Management Highlawn Lab Past Accepting new patients
Ironton Emergency Physicians Inc Past Accepting new patients

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321574400000",
    "number": "1669410510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 88",
            "address_2": "5 E ALVON ROAD SUITE 7",
            "city": "WHITE SULPHUR SPRINGS",
            "state": "WV",
            "postal_code": "249862373",
            "telephone_number": "304-536-5030",
            "fax_number": "304-536-5031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2860 3RD AVE",
            "address_2": "SUITE 230",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257021454",
            "telephone_number": "304-525-3711",
            "fax_number": "304-525-2748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURNETTE",
        "first_name": "DAVID",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-03",
        "last_updated": "2011-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WV",
            "license": "00931",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORKERS COMPENSATION",
            "identifier": "3001162",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00949891",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "001719576",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100170150",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2011; 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.