NPIMap

Organization Active NPI

Burton Urgent Care PLLC

  • General Practice Physician
  • Burton, MI
National Provider Identifier
1790174076
Registry record updated Apr 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
BURTON URGENT CARE PLLC
Practice address
1501 S Center Rd BLDG a
Burton, MI 48509-1731
Phone
(810) 820-8706
Fax
(810) 742-7990
NPI assigned
Jan 9, 2015
Last updated
Apr 24, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2015

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

Authorized official

Name
Dr. Khaled Shukairy, M.D.NPI 1518961879
Title
Owner
Phone
(810) 742-0225

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

1501 S Center Rd BLDG a
Burton, MI 48509-1731

Mailing address

1501 S Center Rd BLDG a
Burton, MI 48509-1731
Phone (810) 820-8706

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150512001855 MI Part B Supplier - Clinic/Group Practice 0345569406 Receives reassigned benefits from 12 practitioners
Practice locations: Burton, MI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1420761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429833600000",
    "number": "1790174076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 S CENTER RD BLDG A",
            "city": "BURTON",
            "state": "MI",
            "postal_code": "485091731",
            "telephone_number": "810-820-8706",
            "fax_number": "810-742-7990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 S CENTER RD BLDG A",
            "city": "BURTON",
            "state": "MI",
            "postal_code": "485091731",
            "telephone_number": "810-820-8706",
            "fax_number": "810-742-7990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BURTON URGENT CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-09",
        "last_updated": "2015-04-24",
        "status": "A",
        "authorized_official_last_name": "SHUKAIRY",
        "authorized_official_first_name": "KHALED",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "810-742-0225",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burton, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.