Individual provider Active NPI

Kent Reynolds Burress, DPM

  • Podiatrist
  • Evansville, IN
National Provider Identifier
1861474058
Registry record updated Feb 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
0700515 Issued in IN
Practice address
1819 Washington Ave
Evansville, IN 47714
Phone
(812) 457-7020
Fax
(812) 477-0200
NPI assigned
Nov 15, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 7, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 0700515 IN Primary

Addresses

Primary practice location

1819 Washington Ave
Evansville, IN 47714

Mailing address

1819 Washington Ave
Evansville, IN 47714
Phone (812) 477-0200

Other identifiers 1

IdentifierTypeStateIssuer
100246800AMedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110804000478 IN Practitioner - Podiatry 2769651991 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
William M. Scholl College of Podiatric Medicine, 1982
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1819 Washington Ave
Evansville, IN 47714-2159
Phone (812) 477-0200

Hospital & facility affiliations

  • Ascension St Vincent Evansville Hospital, Evansville, IN, CCN 150100

Merit-based Incentive Payment System (MIPS)

Final score
97.5 of 100Reported as individual
Quality
95
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions44
Removal of nail tissue77

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0700515INMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Kent R. Burress, DPM, LLC CurrentSince Aug 3, 1982 Accepting new patients

Locations

1819 Washington Ave
Evansville, IN 47714
Phone (812) 477-0200

Organizations & group practices 1

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1132012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202342400000",
    "number": "1861474058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1819 WASHINGTON AVE",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "47714",
            "telephone_number": "812-477-0200",
            "fax_number": "812-477-1267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1819 WASHINGTON AVE",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "47714",
            "telephone_number": "812-457-7020",
            "fax_number": "812-477-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURRESS",
        "first_name": "KENT",
        "middle_name": "REYNOLDS",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-15",
        "last_updated": "2008-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "IN",
            "license": "0700515",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100246800A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

Verify at the official NPI Registry.