Provider Type Icon

DAVID WAYNE BURNSIDE M.D. MBA NPI 1124045752


NPI Information

NPI: 1124045752
Provider Name: DAVID WAYNE BURNSIDE, M.D., MBA
Classification: Emergency Medicine - 207P00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
1 MEMORIAL DR
ALTON, IL
ZIP 62002
Phone: (618) 463-7311
Get Directions

David Wayne Burnside, M.D., MBA is an emergency medicine in Alton, IL with 36 years of experience. The provider is an emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. David Wayne Burnside, M.D., MBA NPI is 1124045752. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF TEXAS MEDICAL SCHOOL AT SAN ANTONIO
Graduation Year:1988

The provider's business location address is:

1 MEMORIAL DR
ALTON, IL
ZIP 62002-722
Phone: (618) 463-7311

The NPI 1124045752 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 7/17/2006 and was last updated on 5/13/2009.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207P00000XEmergency Medicine2666KENTUCKYNo
2207P00000XEmergency Medicine107364MISSOURINo
3207P00000XEmergency Medicine25.067203OHIONo
4207P00000XEmergency Medicine036-090895ILLINOISYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1208063727MEDICAIDMISSOURI
2036090895-3MEDICAIDILLINOIS
3937094748MEDICARE PINMISSOURI
4E39227MEDICARE UPIN
5036090895MEDICAIDILLINOIS
6937094740MEDICARE PINMISSOURI
7000013209MEDICARE PINMISSOURI
8L75316MEDICARE PINILLINOIS
9017013212MEDICARE PINMISSOURI

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.