Organization Active NPI

Robert W. Burdick, M.D.

  • General Practice Physician
  • Sherrill, NY
National Provider Identifier
1952597650
Registry record updated Dec 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
151895 Issued in NY
Legal business name
ROBERT W. BURDICK, M.D.
Practice address
803 Sherrill Rd
Sherrill, NY 13461-1455
Phone
(315) 363-0550
Fax
(315) 363-0787
NPI assigned
Sep 18, 2007
Last updated
Dec 10, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2007

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

Authorized official

Name
Dr. Robert Wesley Burdick, M.D.NPI 1235234956
Title
Owner/Physician
Phone
(315) 363-0550

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208D00000X 151895 NY Primary

Addresses

Primary practice location

803 Sherrill Rd
Sherrill, NY 13461-1455

Mailing address

803 Sherrill Rd
Sherrill, NY 13461-1455
Phone (315) 363-0550

Other identifiers 1

IdentifierTypeStateIssuer
00997700MedicaidNY

National Provider Directory

National Provider Directory

Locations

803 Sherrill Rd
Sherrill, NY 13461
Phone (315) 363-0550

Practitioners & affiliated clinicians

Practitioners 4

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": "1190073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197244800000",
    "number": "1952597650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "803 SHERRILL RD",
            "city": "SHERRILL",
            "state": "NY",
            "postal_code": "134611455",
            "telephone_number": "315-363-0550",
            "fax_number": "315-363-0787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "803 SHERRILL RD",
            "city": "SHERRILL",
            "state": "NY",
            "postal_code": "134611455",
            "telephone_number": "315-363-0550",
            "fax_number": "315-363-0787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT W. BURDICK, M.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-18",
        "last_updated": "2007-12-10",
        "status": "A",
        "authorized_official_last_name": "BURDICK",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "WESLEY",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "315-363-0550",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "NY",
            "license": "151895",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00997700",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sherrill, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2007; 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.