Individual provider Active NPI

Landon Daniel Burris, DC

  • Chiropractor
  • Grand Rapids, MI
National Provider Identifier
1043917008
Registry record updated Nov 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301010726 Issued in MI
Practice address
833 Kenmoor Ave SE
Grand Rapids, MI 49546-2390
Phone
(616) 333-2322
Fax
(616) 772-9258
NPI assigned
Feb 10, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3676 TN
Chiropractor 111N00000X 2301010726 MI Primary

Addresses

Primary practice location

833 Kenmoor Ave SE
Grand Rapids, MI 49546-2390

Mailing address

833 Kenmoor Ave SE
Grand Rapids, MI 49546-2390
Phone (616) 333-2322

Other practice location 1

300 S State St Ste 4
Zeeland, MI 49464-1677
Phone (616) 772-9255

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, MI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230307000000 TN Practitioner - Chiropractic 1254704679 Reassigns benefits to 1 organization
I20250103000992 MI Practitioner - Chiropractic 1254704679 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2018
Medicare assignment
May accept Medicare assignment
Group practices
Balanced Health Chiropractic CenterGroup PAC ID 2466349774, 3 clinicians

Practice addresses (Care Compare)

1787 Grand Ridge CT NE
Suite 103
Grand Rapids, MI 49525-7042
Phone (616) 333-2322

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3676TNMDProfessional Counselor
2301010726MIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Precision Spine Specialists, PLLC Chiropractor CurrentSince Feb 23, 2023 Accepting new patients
Balanced Health Chiropractic Center Chiropractor CurrentSince Dec 17, 2024 Accepting new patients
Scheumann Chiropractic PLLC PastSince Jan 1, 2024 Accepting new patients
A Sound Mind Behavioral Health PastSince Feb 23, 2023 Accepting new patients

Locations

300 S State St
Ste 4
Zeeland, MI 49464
Phone (616) 748-9700

321 Billingsly Ct
Franklin, TN 37067
Phone (615) 445-7600

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1675987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732492800000",
    "number": "1043917008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "833 KENMOOR AVE SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495462390",
            "telephone_number": "616-333-2322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "833 KENMOOR AVE SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495462390",
            "telephone_number": "616-333-2322",
            "fax_number": "616-772-9258"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 S State St Ste 4",
            "address_purpose": "LOCATION",
            "city": "Zeeland",
            "state": "MI",
            "postal_code": "494641677",
            "country_code": "US",
            "telephone_number": "616-772-9255",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURRIS",
        "first_name": "LANDON",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-02-10",
        "last_updated": "2024-11-25",
        "certification_date": "2024-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TN",
            "license": "3676",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301010726",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.