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Individual provider Active NPI

Jeffrey Scott Burnell, DO

  • Family Medicine Physician
  • Maumee, OH
National Provider Identifier
1740573567
Registry record updated Jan 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
34011393 Issued in OH
Practice address
660 Beaver Creek Cir
# 110
Maumee, OH 43537-1745
Phone
(419) 891-6210
Fax
(419) 893-3232
NPI assigned
May 26, 2011
Last updated
Jan 8, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 34011393 OH Primary
Sports Medicine (Family Medicine) Physician 207QS0010X 34-011393 OH

Addresses

Primary practice location

660 Beaver Creek Cir
# 110
Maumee, OH 43537-1745

Mailing address

660 Beaver Creek Cir
# 110
Maumee, OH 43537-1745
Phone (419) 891-6210

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140723002285 OH Practitioner - Family Practice 4688890841 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Michigan State University College of Osteopathic Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

732 S Ave
Toledo, OH 43609-2768
Phone (419) 255-7883

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
34011393OHMDFamily Medicine Physician
34-011393OHMDSports Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Neighborhood Health Association of Toledo, Inc Current Accepting new patients
Neighborhood Health Association of Toledo, Inc. CurrentSince Mar 4, 2025 Accepting new patients
Neighborhood Health Association of Toledo, Inc. CurrentSince Mar 4, 2025 Accepting new patients
Neighborhood Health Association of Toledo, Inc Current Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

225 N Irwin Rd
Holland, OH 43528
Phone (419) 214-4354

1020 Varland Ave
Toledo, OH 43605
Phone (419) 691-1429

117 Main St
Toledo, OH 43605
Phone (419) 691-1322

1415 Jefferson Ave
Toledo, OH 43604
Phone (419) 214-5700

1425 Starr Ave
Toledo, OH 43605
Phone (419) 214-4673

313 Jefferson Ave
Toledo, OH 43604
Phone (419) 214-1770

430 Nebraska Ave
Toledo, OH 43604
Phone (419) 671-5400

544 E Woodruff Ave
Toledo, OH 43604
Phone (419) 214-4673

732 South Ave
Toledo, OH 43609
Phone (419) 241-6106

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1306368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515369600000",
    "number": "1740573567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 BEAVER CREEK CIR",
            "address_2": "# 110",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "435371745",
            "telephone_number": "419-891-6210",
            "fax_number": "419-893-3232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "660 BEAVER CREEK CIR",
            "address_2": "# 110",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "435371745",
            "telephone_number": "419-891-6210",
            "fax_number": "419-893-3232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURNELL",
        "first_name": "JEFFREY",
        "middle_name": "SCOTT",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-26",
        "last_updated": "2018-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "34011393",
            "primary": true
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "OH",
            "license": "34-011393",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maumee, OH

Sources for this page

Verify at the official NPI Registry.