Individual provider Active NPI

Jameson Burdette, MD

  • Pediatrics Physician
  • Augusta, GA
National Provider Identifier
1972235380
Registry record updated Jul 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
14172 Issued in GA
Practice address
1446 Harper St
Augusta, GA 30912-0012
Phone
(706) 721-5437
NPI assigned
Jun 26, 2022
Last updated
Jul 8, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 14172 GA Primary

Addresses

Primary practice location

1446 Harper St
Augusta, GA 30912-0012

Mailing address

102 Creekside Dr
Pendleton, SC 29670-8951

Other practice location 1

2018 Clinch Ave
Knoxville, TN 37916-2301
Phone (865) 541-8105

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
I20220714000354 GA Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 9032590682

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14172GAMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1656201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751932800000",
    "number": "1972235380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 CREEKSIDE DR",
            "city": "PENDLETON",
            "state": "SC",
            "postal_code": "296708951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1446 HARPER ST",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309120012",
            "telephone_number": "706-721-5437"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2018 Clinch Ave",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379162301",
            "country_code": "US",
            "telephone_number": "865-541-8105",
            "fax_number": "865-541-8713",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURDETTE",
        "first_name": "JAMESON",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-06-26",
        "last_updated": "2025-07-08",
        "certification_date": "2025-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "14172",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

Verify at the official NPI Registry.