Jerald Miller Burgess, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

17906 Issued in KY

Practice address

19 Medical Loop
Suite #3
Whitley City, KY 42653-4382

Phone

(606) 376-5391

Fax

(606) 376-3326

NPI assigned

Jan 2, 2007

Last updated

Apr 22, 2015By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: burgess.jerald.002.0170014@cfmc.meditab.direct-ci.com

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.

• Burgess Drug Store Inc

  • Pharmacy
  • Stearns, KY
  • NPI 1598235996
  NPD (past)

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429660800000",
    "number": "1831256957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1080",
            "city": "BURKESVILLE",
            "state": "KY",
            "postal_code": "427171080",
            "telephone_number": "270-864-1472",
            "fax_number": "270-864-1693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 MEDICAL LOOP",
            "address_2": "SUITE #3",
            "city": "WHITLEY CITY",
            "state": "KY",
            "postal_code": "426534382",
            "telephone_number": "606-376-5391",
            "fax_number": "606-376-3326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURGESS",
        "first_name": "JERALD",
        "middle_name": "MILLER",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-02",
        "last_updated": "2015-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "17906",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64179062",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kimberly Margarett Brumley, APRN
• Mark Anthony Bryant, PA-C
• Buckeye Home Health Center, Inc. (Buckeye Home Medical Equipment)
• Burgess Drug Store Inc (Burgess Drugs)
• Burgess Drug Store Inc
• Butterfly Behavior Therapy Group LLC
• Jennifer Casey, LPC
• Stephanie Cash-Smith, FNP
• Thuresa S. Cash, APRN
• Melissa Beth Cheng, MSN, FNP

• Family Medicine Physician in Whitley City, KY
• Providers in Whitley City, KY by specialty
• Family Medicine Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.