Individual provider Active NPI

Kenneth D Burch, MD

  • Pediatric Cardiology Physician
  • Savannah, GA
National Provider Identifier
1891804456
Registry record updated Dec 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
025590 Issued in GA
Practice address
4750 Waters Ave
Suite 512
Savannah, GA 31404-6200
Phone
(912) 350-8085
Fax
(912) 350-3703
NPI assigned
Aug 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology Physician 2080P0202X 025590 GA Primary

Addresses

Primary practice location

4750 Waters Ave
Suite 512
Savannah, GA 31404-6200

Mailing address

4700 Waters Ave
2ND Floor Ga Ear
Savannah, GA 31404-6220
Phone (912) 988-5050

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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

Enrollment IDStateProvider typePAC IDDetails
I20101027000482 GA Practitioner - Cardiovascular Disease (Cardiology) 7113111865 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Medical College of Georgia School of Medicine, 1982
Medicare assignment
May accept Medicare assignment
Group practices
Savannah Children'S Heart Center, PCGroup PAC ID 6002917465, 4 clinicians

Practice addresses (Care Compare)

4700 Waters Ave
Savannah, GA 31404-6220
Phone (912) 988-5050

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
025590GAMDPediatric Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Savannah Children'S Heart Center, PC Pediatric Cardiology CurrentSince Jul 1, 1995 Accepting new patients

Locations

4700 Waters Ave
Bldg 400
Savannah, GA 31404
Phone (912) 350-3438

4750 Waters Ave
Ste 512
Savannah, GA 31404
Phone (912) 350-8085

4700 Waters Ave
Savannah, GA 31404
Phone (912) 273-1100

4700 Waters Ave
Fl 2
Savannah, GA 31404
Phone (912) 350-6277

Interoperability endpoints

  • Direct secure messaging: kburch@schc.gwaydirect.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354579200000",
    "number": "1891804456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 WATERS AVE",
            "address_2": "2ND FLOOR GA EAR",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314046220",
            "telephone_number": "912-988-5050",
            "fax_number": "912-988-5013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4750 WATERS AVE",
            "address_2": "SUITE 512",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314046200",
            "telephone_number": "912-350-8085",
            "fax_number": "912-350-3703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURCH",
        "first_name": "KENNETH",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2012-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "GA",
            "license": "025590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

Verify at the official NPI Registry.