DR. CHARLES K BURLISON (M.D.) – Obstetrics & Gynecology Physician, NPI 1366481434
Obstetrics & Gynecology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
929 OBSTETRICS/GYNECOLOGY in MO
Provider Addresses for DR. CHARLES K BURLISON (M.D.)
1165 N Butterfield Rd
Bolivar, MO 656131056
Phone: (314) 849-0311
Fax: (314) 849-4423
Type: Location
1512 W KIRBY PL
SHREVEPORT, LA 711033822
Phone: (318) 626-0287
Type: Mailing
1541 KINGS HWY
SHREVEPORT, LA 711034228
Phone: (318) 626-0000
Type: Location
12639, Old Tesson Road, Saint Louis County, Missouri, 63128, United States
SUITE 115
SAINT LOUIS, MO 631282786
Phone: (314) 849-0311
Fax: (314) 849-4423
Type: Mailing
1165, North Butterfield Road, Bolivar, Polk County, Missouri, 65613, United States
BOLIVAR, MO 656131056
Phone: (314) 849-0311
Fax: (314) 849-4423
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $15.
Total Amount is formed as General ($15) + Research ($0) + Ownership ($0) = $15.
Last reported payment date: 2024-09-13 • Largest payer in this snapshot: Galderma Laboratories, L.P. ($15).
Total Amount
$15
General + Research + Ownership
Payments
1
Total payment records
General Amount
$15
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-09-13
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Galderma Laboratories, L.P. | $15 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2015-10-06
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20040830000073 | I | Obstetrics/Gynecology | LA | TBD |
| I20151006000051 | I | Obstetrics/Gynecology | FL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 65613)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | LA | |
| Emergency Medicine | LA | |
| - | LA | |
| - | LA | |
| - | LA | |
| Family Practice, Emergency Medicine | LA | |
| - | LA | |
| - | LA | |
| - | LA | |
| - | LA |
Reviews
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