J. Randolph Burnham PH.D.,P.C.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

464 Issued in CT

Legal business name

J. RANDOLPH BURNHAM PH.D.,P.C.

Practice address

18 Kings Hwy S
Westport, CT 06880-4710

Phone

(203) 227-7199

NPI assigned

Jan 10, 2007

Organization subpart

No

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

Authorized official

Name

J. Randolph Burnham, PH.D.NPI 1417005554

Title

President

Phone

(203) 227-7199

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• J. Randolph Burnham, PH.D.

  • Psychologist
  • Westport, CT
  • NPI 1417005554
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1992854483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 KINGS HWY S",
            "city": "WESTPORT",
            "state": "CT",
            "postal_code": "068804710",
            "telephone_number": "203-227-7199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 KINGS HWY S",
            "city": "WESTPORT",
            "state": "CT",
            "postal_code": "068804710",
            "telephone_number": "203-227-7199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J. RANDOLPH BURNHAM PH.D.,P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BURNHAM",
        "authorized_official_first_name": "J. RANDOLPH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "203-227-7199",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "CT",
            "license": "464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter Iocovello
• Cristina Roxana Ionescu, M.D.
• Ryan Christopher Isacsson, PHARMD
• Beverly Gershon Isenberg, LPC
• Robert A Israely, M.D.
• Erin Jackson, LCSW
• Rebecca Jacobson, L.C.S.W.
• Leigh Libling Jaffe, LMSW
• Cindy Lee James, PHD PSYCHOLOGIST
• Kanokwan Jatuparisuthiseen

• Psychologist in Westport, CT
• Providers in Westport, CT by specialty
• Psychologist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.