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Contact Information

JASON S BURGESS, MD
1918 RANDOLPH RD STE 300
CHARLOTTE, NC28207-1112
 Phone: 704-333-0741
 Fax: 704-333-3356
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Surgery

208600000X 02 Physician/General Surgery
 

Vascular Surgery

2086S0129X 76 Physician/Peripheral Vascular Disease
Indicates primary specialty

NPI Profile & details for JASON S BURGESS · (Male)

NPI # 1043201361
Status Active
Credentials MD
Entity Individual
Enumeration date 11/04/2005
Last updated 11/05/2025 - About 7 months ago
Sole proprietor 1 No
Identifiers
  • NC License # 200200093
  • NC Medicaid 891305A
  • Other 2000396 MEDICARE
  • Other 2000396D MEDICARE PIN FACULTY
Hospital affiliation(s)
  • CAROLINAS MEDICAL CENTER/BEHAV HEALTH - (Acute Care)
    1000 BLYTHE BLVD
    CHARLOTTE, NC 28203
  • PRESBYTERIAN HOSPITAL - (Acute Care)
    200 HAWTHORNE LANE BOX 33549
    CHARLOTTE, NC 28233
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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