Active NPI
Roger Lee Burch, O.D.
- Optometrist
- Caney, KS
National Provider Identifier
1730284274
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 1031-3
- Practice address
- 124 W 4TH Ave
Caney, KS 67333-1460 - Phone
- (620) 879-2020
- Fax
- (620) 879-5381
- NPI assigned
- Sep 13, 2006
- Last updated
- Feb 7, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1031-3 | KS | Primary |
Addresses
Primary practice location
124 W 4TH Ave
Caney, KS 67333-1460
Mailing address
PO Box 39
Caney, KS 67333-0039
Phone (620) 879-2415
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100091060A | Medicaid | KS |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1031-3 | KS | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158105600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1202342400000",
"number": "1730284274",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 39",
"city": "CANEY",
"state": "KS",
"postal_code": "673330039",
"telephone_number": "620-879-2415"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "124 W 4TH AVE",
"city": "CANEY",
"state": "KS",
"postal_code": "673331460",
"telephone_number": "620-879-2020",
"fax_number": "620-879-5381"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURCH",
"first_name": "ROGER",
"middle_name": "LEE",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-13",
"last_updated": "2008-02-07",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "KS",
"license": "1031-3",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100091060A",
"state": "KS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Caney, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.