Individual provider Active NPI

Larry Thomas Burks, D.C.

  • Chiropractor
  • Lake Oswego, OR
National Provider Identifier
1043559867
Registry record updated Feb 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5120 Issued in OR
Practice address
15800 Upper Boones Ferry Rd
Suite 400
Lake Oswego, OR 97035-4085
Phone
(503) 597-8352
NPI assigned
Feb 14, 2013
Last updated
Feb 14, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5120 OR Primary

Addresses

Primary practice location

15800 Upper Boones Ferry Rd
Suite 400
Lake Oswego, OR 97035-4085

Mailing address

15800 Upper Boones Ferry Rd
Suite 400
Lake Oswego, OR 97035-4085
Phone (503) 597-8352

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5120ORMDChiropractor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1360800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360800000000",
    "number": "1043559867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15800 UPPER BOONES FERRY RD",
            "address_2": "SUITE 400",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970354085",
            "telephone_number": "503-597-8352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15800 UPPER BOONES FERRY RD",
            "address_2": "SUITE 400",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970354085",
            "telephone_number": "503-597-8352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURKS",
        "first_name": "LARRY",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-02-14",
        "last_updated": "2013-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "5120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Oswego, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.