Jefferson M Burroughs, MD

Primary specialty

Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X

License

35.060636 Issued in OH

Practice address

3000 Mack Rd
Suite 100
Fairfield, OH 45014-5335

Phone

(513) 751-4222

Fax

(513) 751-4353

NPI assigned

Jul 15, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in OH

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

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 and National Provider Directory roles.

• Mercy Health Physicians Cincinnati Specialty Care LLC

  • Surgery Physician
  • Blue Ash, OH
  • NPI 1154942795

  Cardiovascular Disease

  Medicare reassignment NPD
• Mercy Health Physicians Cincinnati LLC

  • Durable Medical Equipment & Medical Supplies
  • Liberty Township, OH
  • NPI 1790281517
  NPD
• Mercy Health Physicians Cincinnati Specialty Care LLC

  • Durable Medical Equipment & Medical Supplies
  • Liberty TWP, OH
  • NPI 1730993270
  NPD
• Mercy Health Physicians Cincinnati, LLC

  • Family Medicine Physician
  • Blue Ash, OH
  • NPI 1205887023

  Cardiovascular Disease

  NPD

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

{
    "created_epoch": "1121385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447286400000",
    "number": "1740289453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 MACK RD",
            "address_2": "SUITE 100",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450145335",
            "telephone_number": "513-751-4222",
            "fax_number": "513-751-4353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 MACK RD",
            "address_2": "SUITE 100",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450145335",
            "telephone_number": "513-751-4222",
            "fax_number": "513-751-4353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURROUGHS",
        "first_name": "JEFFERSON",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-15",
        "last_updated": "2015-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OH",
            "license": "35.060636",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "OH",
            "license": "35.060636",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100383700",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0807587",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0773102",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sean G Buffington, SWT
• Bullock Dialysis LLC
• Adrienne Bullock
• Barbara Jean Bunting, MSN, RN, ANP-BC
• Michelle L Burch, M.D.
• Angela Marie Burton, LPN
• Butler County Community Health Consortium, Inc.
• Butler County Community Health Consortium, Inc.
• Graderiah La'Tifah Butler, LPN
• C Crystal Psych

• Clinical Cardiac Electrophysiology Physician in Fairfield, OH
• Providers in Fairfield, OH by specialty
• Clinical Cardiac Electrophysiology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.