JEREMY J BURDGE M.D. NPI 1235113408

NPI Information

NPI: 1235113408
Provider Name: JEREMY J BURDGE, M.D.
Classification: Specialist - 174400000X
Entity Type: Individual

PECOS Registration: Yes

Address:
3732 OLENTANGY RIVER RD
SUITE C
COLUMBUS, OH
ZIP 43214
Phone: (614) 451-0411
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Jeremy J Burdge, M.D. is a specialist in Columbus, OH. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. Jeremy J Burdge, M.D. NPI is 1235113408. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

3732 OLENTANGY RIVER RD
SUITE C
COLUMBUS, OH
ZIP 43214-449
Phone: (614) 451-0411
Fax: (614) 451-8037

The NPI 1235113408 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 12/1/2005 and was last updated on 8/30/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	208200000X	Plastic Surgery		35.042744	OHIO	No
2	174400000X	Specialist		35-042744	OHIO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	BU0547684	MEDICARE ID-TYPE UNSPECIFIED	OHIO	MEDICARE ID
2	0553753	MEDICAID	OHIO
3	000000118889	OTHER	OHIO	ANTHEM PROVIDER ID
4	A80856	MEDICARE UPIN	OHIO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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