1538498159 NPI number — LAWRENCE E. BURNS, DPM, INC

Table of content: (NPI 1538498159)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538498159 NPI number — LAWRENCE E. BURNS, DPM, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LAWRENCE E. BURNS, DPM, INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
DR. LAWRENCE E BURNS, DPM
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1538498159
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/10/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
104 WOODMONT BLVD
Provider Second Line Business Mailing Address:
SUITE LL50
Provider Business Mailing Address City Name:
NASHVILLE
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37205-2245
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
615-386-2300
Provider Business Mailing Address Fax Number:
615-386-2399

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4230 HARDING RD
Provider Second Line Business Practice Location Address:
SUITE G-12
Provider Business Practice Location Address City Name:
NASHVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37205-2013
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
615-301-7054
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/10/2009

Additional Information

Authorized Official

Authorized Official Last Name:
BURNS
Authorized Official First Name:
LAWRENCE
Authorized Official Middle Name:
E
Authorized Official Title or Position:
SOLE PROPRIETOR
Authorized Official Telephone Number:
615-386-2300

Provider Taxonomy Codes

  • Taxonomy code: 332BC3200X , with the licence number:  0531 DPM , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 335E00000X , with the licence number: 0531 DPM , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: TN0173 . This is a "AMERICHOICE MCD" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 01040363 . This is a "AMERIGROUP MCD & MCR ADVANTAGE" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 1104535 . This is a "WINDSOR MEDICARE ADVANTAGE" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 7100042140 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3353057 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 480029698 . This is a "MEDICARE RAILROAD" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 173095 . This is a "DOL FECA" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 4389487 . This is a "AETNA" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 3146270 . This is a "BLUE CROSS OF TN" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 344395 . This is a "USA MANAGED CARE" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 2226259 . This is a "CIGNA" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".




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