Susan Walters Burkholder, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

01031490A Issued in IN

Practice address

703 Pro-Med LN
Carmel, IN 46032-5317

Phone

(317) 843-9922

Fax

(317) 581-3918

NPI assigned

Nov 28, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jul 15, 2016 through Jul 15, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Major Hospital

  • General Acute Care Hospital
  • Shelbyville, IN
  • NPI 1174555692
  NPD (past)
• Midwest Medical Management, P.C.

  • Emergency Medicine Physician
  • Terre Haute, IN
  • NPI 1417996430
  NPD (past)

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473120000000",
    "number": "1750457974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 PRO-MED LN",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460325317",
            "telephone_number": "317-843-9922",
            "fax_number": "317-581-3918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 PRO-MED LN",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460325317",
            "telephone_number": "317-843-9922",
            "fax_number": "317-581-3918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURKHOLDER",
        "first_name": "SUSAN",
        "middle_name": "WALTERS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-28",
        "last_updated": "2016-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01031490A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Bundy, MHS, PT
• Teresa Lynn Bunton, BCBA
• Richard Burgett, MD
• Cayla J Burke, NP
• Kristen Michelle Burke, LCSW
• Ashley Marie Burks, NP
• Andrea Burnett-Sircy
• Riesa M. Burnett, MD
• Charles P Burney, MD
• Mary Burnworth

• Family Medicine Physician in Carmel, IN
• Providers in Carmel, IN by specialty
• Family Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2016; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.