Bruce Ellis Burner Sr., M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

12643 Issued in SC

Practice address

618 N Main St
Marion, SC 29571-3034

Phone

(843) 433-8010

Fax

(843) 433-8692

NPI assigned

Dec 2, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Carolina Family Care, Inc

  • Family Medicine Physician
  • Charleston, SC
  • NPI 1184655722
  Medicare reassignment NPD
• Main Street Medical Associates LLC

  • Family Medicine Physician
  • Marion, SC
  • NPI 1144822735
  Medicare reassignment NPD
• Musc Community Physicians

  • Internal Medicine Physician
  • Bamberg, SC
  • NPI 1841878006

  Emergency Medicine

  Medicare reassignment NPD
• Carolina Family Care, Inc

  • Family Medicine Physician
  • Florence, SC
  • NPI 1093076457
  NPD
• Musc Community Physicians

  • Rural Health Clinic/Center
  • Bowman, SC
  • NPI 1225735772
  NPD
• Musc Community Physicians

  • Family Medicine Physician
  • Bamberg, SC
  • NPI 1992383145
  NPD
• QHG of South Carolina Inc

  • Medicare Defined Swing Bed Hospital Unit
  • Mullins, SC
  • NPI 1932464708
  NPD (past)

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

{
    "created_epoch": "1133481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682294400000",
    "number": "1891779807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1440",
            "city": "MARION",
            "state": "SC",
            "postal_code": "295711440",
            "telephone_number": "843-433-8010",
            "fax_number": "843-433-8692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "618 N MAIN ST",
            "city": "MARION",
            "state": "SC",
            "postal_code": "295713034",
            "telephone_number": "843-433-8010",
            "fax_number": "843-433-8692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURNER",
        "first_name": "BRUCE",
        "middle_name": "ELLIS",
        "name_prefix": "Dr.",
        "name_suffix": "Sr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-02",
        "last_updated": "2023-04-24",
        "certification_date": "2023-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "SC",
            "license": "12643",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "12643",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "126438",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Zakia Brisbon, PHARM.D
• Jennifer Brown, LPC
• Burgess Primary Family Practice LLC
• Vanessa Burgess
• Valerie Burke, M.D.,F.A.C.O.G.
• Canaan Land Community Development Center
• Carolina Pharmacy Inc.
• Carolynmichael Lifestyle and Business Services, LLC
• Beverly Causey, R.N.
• Marty U Chaplin, MA CCC-SLP

• Family Medicine Physician in Marion, SC
• Providers in Marion, SC by specialty
• Family Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.