Robert S Burnside, LISW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I-05142 Issued in NM

Practice address

4800 College Blvd
Suite 102
Farmington, NM 87402-4710

Phone

(505) 326-3566

Fax

(505) 326-5698

NPI assigned

Mar 5, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1267747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267747200000",
    "number": "1962725945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 COLLEGE BLVD",
            "address_2": "SUITE 102",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874024710",
            "telephone_number": "505-326-3566",
            "fax_number": "505-326-5698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 COLLEGE BLVD",
            "address_2": "SUITE 102",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874024710",
            "telephone_number": "505-326-3566",
            "fax_number": "505-326-5698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURNSIDE",
        "first_name": "ROBERT",
        "middle_name": "S",
        "name_prefix": "Mr.",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-03-05",
        "last_updated": "2010-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "I-05142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Rose Burke, CRNA
• Teija Yvette Burks, DPT
• Mark Burnham, RN
• Robert Joseph Burns, M.D.
• Susan L Burns, HIS
• James F Burpee, M.D.
• Valentina Elizabeth Burrola, MSW, LCSW
• Teri Gay Burton
• Vickie Busby, LADAC
• Christian Wolfram Butler, PA-C

• Clinical Social Worker in Farmington, NM
• Providers in Farmington, NM by specialty
• Clinical Social Worker in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2010; 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.