Jack Burton

Primary specialty

Hematology & Oncology PhysicianTaxonomy code 207RH0003X

License

215596-1 Issued in NY

Practice address

9930 Kincey Ave Ste 165
Huntersville, NC 28078-6541

Phone

(704) 947-5005

Fax

(877) 881-8455

NPI assigned

Aug 10, 2006

Last updated

Aug 27, 2021By 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 NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Medical OncologyAlso: Hematology

Education

University of Minnesota Medical School, 1981

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southern Oncology Specialists PLLCGroup PAC ID 4082739560, 14 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Novant Health Huntersville Medical Center Hospital, Huntersville, NC, CCN 340183
• Novant Health Presbyterian Medical Center Hospital, Charlotte, NC, CCN 340053
• Iredell Memorial Hospital Inc Hospital, Statesville, NC, CCN 340039

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Southern Oncology Specialists, PLLC

  • Hematology & Oncology Physician
  • Huntersville, NC
  • NPI 1336455674
  Medicare reassignment Care Compare group NPD
• Southern Oncology Specialists, PLLC

  • Specialty Pharmacy
  • Huntersville, NC
  • NPI 1558879965
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Iredell Memorial Hospital, Incorporated

  • General Acute Care Hospital
  • Statesville, NC
  • NPI 1417944224
  Care Compare affiliation
• The Presbyterian Hospital

  dba Novant Health Huntersville Medical Center

  • General Acute Care Hospital
  • Huntersville, NC
  • NPI 1346291309
  Care Compare affiliation
• The Presbyterian Hospital

  dba Presbyterian ESRD Unit

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Charlotte, NC
  • NPI 1396798591

  Hospital

  Care Compare affiliation
• The Presbyterian Hospital

  dba Presbyterian Behavioral Health Unit

  • Psychiatric Hospital Unit
  • Charlotte, NC
  • NPI 1497708838
  Care Compare affiliation
• The Presbyterian Hospital

  dba Novant Health Presbyterian Medical Center

  • General Acute Care Hospital
  • Charlotte, NC
  • NPI 1881647204
  Care Compare affiliation
• The Presbyterian Hospital

  dba Novant Health Presbyterian Medical Center - Skilled Nursing Unit

  • Skilled Nursing Facility
  • Charlotte, NC
  • NPI 1891871901

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630022400000",
    "number": "1700897121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9930 KINCEY AVE STE 165",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280786541",
            "telephone_number": "704-947-5005",
            "fax_number": "877-881-8455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9930 KINCEY AVE STE 165",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280786541",
            "telephone_number": "704-947-5005",
            "fax_number": "877-881-8455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURTON",
        "first_name": "JACK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-10",
        "last_updated": "2021-08-27",
        "certification_date": "2021-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NY",
            "license": "215596-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1700897121",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carlos Burch
• Meagen Burelli, LPCA
• Abby Burkhard
• Jerrell Everton Burnett
• Taylor Burris, BCBA
• Carrie E Bush, MSN, FNP
• Mariela Petrova Busheva, NP-C
• Valerie J Bustamante
• Karen Elizabeth Butler, LPA
• Julia Butlin, M.S, CCC-SLP

• Hematology & Oncology Physician in Huntersville, NC
• Providers in Huntersville, NC by specialty
• Hematology & Oncology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.