Individual provider Active NPI

Kendall Burgess, DC

  • Chiropractor
  • Port Huron, MI
National Provider Identifier
1063300952
Registry record updated Jun 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301401633 Issued in MI
Practice address
2915 Lapeer Rd
Port Huron, MI 48060-7371
Phone
(810) 985-0084
NPI assigned
Jun 27, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301401633 MI Primary

Addresses

Primary practice location

2915 Lapeer Rd
Port Huron, MI 48060-7371

Mailing address

2915 Lapeer Rd
Port Huron, MI 48060-7371
Phone (810) 985-0084

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250723001735 MI Practitioner - Chiropractic 0547776858 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2301401633MIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Leverenz Family Chiropractic PC Chiropractor CurrentSince Jul 2, 2025 Accepting new patients

Organizations & group practices 1

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": "1750982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750982400000",
    "number": "1063300952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2915 LAPEER RD",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480607371",
            "telephone_number": "810-985-0084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2915 LAPEER RD",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480607371",
            "telephone_number": "810-985-0084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURGESS",
        "first_name": "KENDALL",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-27",
        "last_updated": "2025-06-27",
        "certification_date": "2025-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301401633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Huron, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.