Ronald a. Burks OD PA

Primary specialty

OptometristTaxonomy code 152W00000X

License

2273 Issued in AR

Legal business name

RONALD A. BURKS OD PA

Practice address

305 E Kiehl Ave
Sherwood, AR 72120-2921

Phone

(501) 835-3937

Fax

(501) 835-2040

NPI assigned

Dec 21, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Ronald A Burks, OD

Title

President

Phone

(501) 835-3937

Specialties & licenses 1

Addresses

Other identifiers 4

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263859200000",
    "number": "1992869945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 E KIEHL AVE",
            "city": "SHERWOOD",
            "state": "AR",
            "postal_code": "721202921",
            "telephone_number": "501-835-3937",
            "fax_number": "501-835-2040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 E KIEHL AVE",
            "city": "SHERWOOD",
            "state": "AR",
            "postal_code": "721202921",
            "telephone_number": "501-835-3937",
            "fax_number": "501-835-2040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RONALD A. BURKS OD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-21",
        "last_updated": "2010-01-19",
        "status": "A",
        "authorized_official_last_name": "BURKS",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "501-835-3937",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "AR",
            "license": "2273",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "166692722",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "410000403",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DG7408",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AR BLUECROSS BLUESHIELD",
            "identifier": "5F895",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Sherwood, AR
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 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.