NPIMap

Organization Active NPI

Kelly D. Burchett DO LLC

Doing business as Advanced Surgical Arts

  • Otolaryngology/Facial Plastic Surgery Physician
  • Kirksville, MO
National Provider Identifier
1891983037
Registry record updated Oct 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X
License
2001010344 Issued in MO
Legal business name
KELLY D. BURCHETT DO LLC
Doing business as
Advanced Surgical Arts
Practice address
1605 South Baltimore
Suite B
Kirksville, MO 63501
Phone
(660) 665-3599
Fax
(660) 665-3570
NPI assigned
Oct 12, 2007
Last updated
Oct 14, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2011

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

Authorized official

Name
Kelly Douglas Burchett, D.O.NPI 1629161864
Title
Physician
Phone
(660) 665-3599

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology/Facial Plastic Surgery Physician 207YX0905X 2001010344 MO Primary

Addresses

Primary practice location

1605 South Baltimore
Suite B
Kirksville, MO 63501

Mailing address

1605 South Baltimore
Suite B
Kirksville, MO 63501
Phone (660) 665-3599

Other names 1

  • Advanced Surgical Arts Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1192147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318550400000",
    "number": "1891983037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1605 SOUTH BALTIMORE",
            "address_2": "SUITE B",
            "city": "KIRKSVILLE",
            "state": "MO",
            "postal_code": "63501",
            "telephone_number": "660-665-3599",
            "fax_number": "660-665-3599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1605 SOUTH BALTIMORE",
            "address_2": "SUITE B",
            "city": "KIRKSVILLE",
            "state": "MO",
            "postal_code": "63501",
            "telephone_number": "660-665-3599",
            "fax_number": "660-665-3570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLY D. BURCHETT DO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-12",
        "last_updated": "2011-10-14",
        "status": "A",
        "authorized_official_last_name": "BURCHETT",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "DOUGLAS",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "660-665-3599",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "MO",
            "license": "2001010344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Surgical Arts",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kirksville, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2011; 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.