John Stanley Burnham, M.D.
Individual provider Active NPI Family Medicine Physician · Dover, OH
NPI 1790766012 · NPPES record last updated Nov 7, 2016
Key facts
- NPI
- 1790766012
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 35-05-2279B (OH)
- Practice address
- 1716 N Cross St
Dover, OH 44622-1043 - Phone
- (330) 364-8868
- Fax
- (330) 364-4732
- NPI assigned
- Nov 14, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Ohio State University College of Medicine, 1984
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Union Physician Services LLC
Practice addresses (Care Compare)
110 Dublin Dr
Dover, OH 44622-7805
Phone (330) 364-9088
Hospital & facility affiliations
- Union Hospital
- Cleveland Clinic
- Twin City Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20091026000135 | OH | Practitioner - Family Practice | 5890831259 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Union Physician Services, LLC | Family Medicine | Current |
Accepting new patients |
| Kapper Chiropractic Center, Inc. | Past |
Accepting new patients |
Locations
1716 N Cross St
Dover, OH 44622
Phone (330) 364-8868
110 Dublin Dr
#A
Dover, OH 44622
Phone (330) 364-8038
205 Hospital Dr
Dover, OH 44622
Phone (330) 343-3335
110 Dublin Dr
Dover, OH 44622
Phone (330) 343-0753
Interoperability endpoints
- jburnham1237494@direct.ccf.org
- johnburnham@dpfm.allscriptsdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 35-05-2279B | OH | Yes |
Addresses
Primary practice location
1716 N Cross St
Dover, OH 44622-1043
Mailing address
110 Dublin Drive
Suite a
Dover, OH 44622
Phone (330) 364-8868
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0661412 | Medicaid | OH |
Other providers in Dover, OH
- Richard Lee Brown
- Bryan Internal Medicine Specialties, Inc
- Joseph E Bryan
- Larry Duane Bucher
- Jade Marie Burger
- Danielle Burns
- Brock Burris
- Jamie Lynn Butler
- Nicholas Lee Butler
- Cadiz Vision Center LTD
All providers in Dover, OH · Family Medicine Physician in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 7, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.