Organization Active NPI

Ronnelle S Burley MD PA

  • Obstetrics & Gynecology Physician
  • Lubbock, TX
National Provider Identifier
1982806261
Registry record updated Dec 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
RONNELLE S BURLEY MD PA
Practice address
3706 22ND PL
Lubbock, TX 79410-1320
Phone
(806) 722-1253
Fax
(806) 722-0268
NPI assigned
May 31, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2021

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

Authorized official

Name
Ronnelle S. BurleyNPI 1477516219
Title
M.D.
Phone
(806) 785-7676

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
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X Primary

Addresses

Primary practice location

3706 22ND PL
Lubbock, TX 79410-1320

Mailing address

3706 22ND PL
Lubbock, TX 79410-1320
Phone (806) 722-1253

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071017000163 TX Part B Supplier - Clinic/Group Practice 5799878807 Receives reassigned benefits from 2 practitioners
Practice locations: Lubbock, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D1079728Ronnelle Burley MD3706 22ND Place, Lubbock, TX 79410Provider-performed microscopyFeb 5, 2028

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.

NPI Registry JSON

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

{
    "created_epoch": "1180569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638835200000",
    "number": "1982806261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3706 22ND PL",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101320",
            "telephone_number": "806-722-1253",
            "fax_number": "806-722-0268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3706 22ND PL",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101320",
            "telephone_number": "806-722-1253",
            "fax_number": "806-722-0268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RONNELLE S BURLEY MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-31",
        "last_updated": "2021-12-07",
        "certification_date": "2021-12-07",
        "status": "A",
        "authorized_official_last_name": "BURLEY",
        "authorized_official_first_name": "RONNELLE",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "M.D.",
        "authorized_official_telephone_number": "806-785-7676"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.