Mark A. Burkett, D.O.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

02002438A Issued in IN

Practice address

1270 E State Road 205
Suite 150
Columbia City, IN 46725-9499

Phone

(260) 248-9890

Fax

(260) 248-9895

NPI assigned

Dec 6, 2005

Last updated

Mar 25, 2013By the provider in NPPES

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

Other identifiers 7

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Parkview Hospital, Inc.

  • Trauma Surgery Physician
  • Fort Wayne, IN
  • NPI 1669576997
  NPD (past)

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

{
    "created_epoch": "1133827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364169600000",
    "number": "1972587566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1234 E DUPONT RD",
            "address_2": "SUITE 1",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468251545",
            "telephone_number": "260-373-9700",
            "fax_number": "260-373-9740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1270 E STATE ROAD 205",
            "address_2": "SUITE 150",
            "city": "COLUMBIA CITY",
            "state": "IN",
            "postal_code": "467259499",
            "telephone_number": "260-248-9890",
            "fax_number": "260-248-9895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURKETT",
        "first_name": "MARK",
        "middle_name": "A.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-06",
        "last_updated": "2013-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "02002438A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110231565",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE DMEPOS",
            "identifier": "3937240004",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200367950",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4270901",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIANS HEALTH PLAN",
            "identifier": "12730",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000210720",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "00000968827 05",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeffrey A Brookes, M.D.
• Jean E. Buchanan, RPH
• Anna C. Bultemeier, MA
• Elizabeth Bumanglag
• Courtney Bumbaugh, DDS
• Charles Matthew Butler, MA
• Matthew A Byers, M.D.
• C. Bryan Wait, M.D., Internal Medicine,P.C.
• Monica Call, DO
• Randall K. Carpenter, M.D.

• Internal Medicine Physician in Columbia City, IN
• Providers in Columbia City, IN by specialty
• Internal Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2013; 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.