JERRY B BURGESS JR. (NPI# 1083890370) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083890370 |
| Entity Type | Individual |
| Full Name | JERRY B BURGESS JR. |
| Credential | M.D. |
| Practice Address |
210 W Capitol Dr Milwaukee WI 53212-1123 |
| Mailing Address |
300 E Oakland Park Blvd # 194 Oakland Park FL 33334-2148 |
| Practice Telephone | 3134025995 |
| Mailing Telephone | 3134025995 |
| Enumeration Date | 2008-01-16 |
| Last Update Date | 2013-12-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | 50852-020 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 34976500 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114045747 | Jerry Watson Burgess | Dentist | 1105 W Wall St, Grapevine, TX 76051-5152 | 2007-03-26 |
| Street Address |
210 W CAPITOL DR |
| City | MILWAUKEE |
| State | WI |
| Zip Code | 53212-1123 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528029949 | Geoffrey A Scott | Family Medicine | 210 W Capitol Dr, Milwaukee, WI 53212-1123 | 2006-03-28 |
| 1841815586 | Melissa St Antoine | Counselor | 210 W Capitol Dr, Milwaukee, WI 53212-1123 | 2020-06-09 |
| 1639723711 | Amanda Marie Olivas | Nurse Practitioner | 210 W Capitol Dr, Milwaukee, WI 53212-1123 | 2019-07-28 |
| 1851956882 | Juan Felipe Valencia | Dentist | 210 W Capitol Dr, Milwaukee, WI 53212-1123 | 2019-05-06 |
| 1861057085 | Brent Norman Tollerud | Dentist | 210 W Capitol Dr, Milwaukee, WI 53212-1123 | 2019-05-02 |
| 1235690280 | Benjamin Alan Klatt | Nurse Practitioner | 210 W Capitol Dr, Milwaukee, WI 53212-1123 | 2019-03-30 |
| 1063983294 | Michelle Elaine Mckenna | Counselor | 210 W Capitol Dr, Milwaukee, WI 53212-1123 | 2018-12-16 |
| 1811471253 | Kathryn D Kinter | Counselor | 210 W Capitol Dr, Milwaukee, WI 53212-1123 | 2018-09-21 |
| 1760966170 | Michael Frank Potnek | Nurse Practitioner | 210 W Capitol Dr, Milwaukee, WI 53212-1123 | 2018-09-20 |
| 1295247237 | Judy A Conti | Nurse Practitioner | 210 W Capitol Dr, Milwaukee, WI 53212-1123 | 2017-10-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609481001 | Beth Leanna | Counselor | Benedict Center 1849 N Dr. Marin Luther King Dr., Suite 101, Milwaukee, WI 53212 | 2020-09-11 |
| 1326683749 | A.b.d.h. Counseling Services LLC | Clinic/Center | 518 E Concordia Avenue, Milwaukee, WI 53212 | 2019-11-08 |
| 1467095703 | Ifrah Hameed | Psychologist | 1849 N Doctor M.l.k. Jr Dr# 101, Milwaukee, WI 53212 | 2019-10-18 |
| 1386293330 | Rachel Mae Nelson Bagha | Student in an Organized Health Care Education/Training Program | 1849 N Doctor M.l.k. Jr Dr #101, Milwaukee, WI 53212 | 2019-09-11 |
| 1164085205 | Mary Sue Daase Bowen | Counselor | 2821 N 4th Street, Milwaukee, WI 53212 | 2019-04-15 |
| 1649733189 | Stacey King | Counselor | Rivershore Comprehensive Treatment Facility, 3703 N Richards St, Milwaukee Wi, Milwaukee, WI 53212 | 2019-04-11 |
| 1710447701 | Scott William Stauder | Student in an Organized Health Care Education/Training Program | 1121 E. North Ave., Milwaukee, WI 53212 | 2019-03-25 |
| 1821561168 | Lydia Ann Mendez | Counselor | 3703 N Richards St, Milwaukee, WI 53212 | 2019-01-09 |
| 1851863302 | Glen Victor Fleming | Counselor | 2821 North 4th Street Suite 210, Milwaukee, WI 53212 | 2018-12-21 |
| 1093285140 | Megan Marie Volp | Advanced Practice Midwife | 2555 N Doctor M.l.k. Jr Dr, Milwaukee, WI 53212 | 2018-12-03 |
| Find all providers in zip 53212 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871769919 | Richard Winston Meyers | General Practice | 11050 Liberty Dr, Milwaukee, WI 53224-3630 | 2008-05-07 |
| 1144492273 | Amanda Courtney Reiswig | General Practice | 1233 N Mayfair Rd Ste 208, Milwaukee, WI 53226-3255 | 2008-03-28 |
| 1063496131 | Eldon J Swenson | General Practice | 620 S 76th St, Suite 240, Milwaukee, WI 53214-1599 | 2005-12-02 |
| 1467093864 | Der Yang | General Practice | 5800 W Burleigh St, Milwaukee, WI 53210-1516 | 2019-10-07 |
| 1821559550 | Kamal Sammy Al-shalby | General Practice | 8701 W Watertown Plank Rd, Milwaukee, WI 53226-3548 | 2019-03-26 |
| 1659831816 | Rachel Louise Feltman-frank | General Practice | 8701 W Watertown Plank Rd, Milwaukee, WI 53226-3548 | 2019-03-23 |
| 1518427145 | Zabrina Leann Ebert | General Practice | 8701 Watertown Plank Road, Milwaukee, WI 53226-0509 | 2019-03-20 |
| 1104323765 | Kayla Jean Schenheit | General Practice | 8701 W Watertown Plank Rd, Milwaukee, WI 53226-3548 | 2018-04-10 |
| 1831621341 | Peter Devries | General Practice | 8701 W Watertown Plank Rd, Milwaukee, WI 53226-3548 | 2017-04-03 |
| 1962934265 | Hannah M Reiland | General Practice | 8701 W Watertown Plank Rd, Department of Psychiatry and Behavioral Medicine, Milwaukee, WI 53226-3548 | 2017-03-28 |
| Find all providers in MILWAUKEE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.