Active NPI
John M. Burks, M. D.
- Cardiovascular Disease Physician
- Williamsport, PA
National Provider Identifier
1841286879
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- MD019632E
- Practice address
- 700 High St
Williamsport, PA 17701-3198 - Phone
- (570) 321-2800
- Fax
- (570) 321-6490
- NPI assigned
- Sep 26, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | MD019632E | PA | Primary |
Addresses
Primary practice location
700 High St
Williamsport, PA 17701-3198
Mailing address
1201 Grampian Blvd
Suite 1K
Williamsport, PA 17701-1900
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0007832260001 | Medicaid | PA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127692800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1326326400000",
"number": "1841286879",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1201 GRAMPIAN BLVD",
"address_2": "SUITE 1K",
"city": "WILLIAMSPORT",
"state": "PA",
"postal_code": "177011900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 HIGH ST",
"city": "WILLIAMSPORT",
"state": "PA",
"postal_code": "177013198",
"telephone_number": "570-321-2800",
"fax_number": "570-321-6490"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURKS",
"first_name": "JOHN",
"middle_name": "M.",
"name_prefix": "Dr.",
"credential": "M. D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-26",
"last_updated": "2012-01-12",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "PA",
"license": "MD019632E",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0007832260001",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Williamsport, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.