Active NPI
Jonathan Burack, DC
- Chiropractor
- Dover, DE
National Provider Identifier
1083759674
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- FI0000580
- Practice address
- 871 S Governors Ave
Ste 2
Dover, DE 19904 - Phone
- (302) 734-1150
- Fax
- (302) 734-1160
- NPI assigned
- Feb 21, 2007
- Last updated
- Oct 1, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | FI0000580 | DE | Primary |
Addresses
Primary practice location
871 S Governors Ave
Ste 2
Dover, DE 19904
Mailing address
871 S Governors Ave
Ste 2
Dover, DE 19904
Phone (302) 734-1150
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DE
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040802001366 | DE | Practitioner - Chiropractic | 6608847975 | Practice locations: Dover, DE |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Life Chiropractic College, 2001
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
871 S Governors Ave
Dover, DE 19904-4115
Phone 3027341150302
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| FI0000580 | DE | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172016000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1349049600000",
"number": "1083759674",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "871 S GOVERNORS AVE",
"address_2": "STE 2",
"city": "DOVER",
"state": "DE",
"postal_code": "19904",
"telephone_number": "302-734-1150",
"fax_number": "302-734-1160"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "871 S GOVERNORS AVE",
"address_2": "STE 2",
"city": "DOVER",
"state": "DE",
"postal_code": "19904",
"telephone_number": "302-734-1150",
"fax_number": "302-734-1160"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURACK",
"first_name": "JONATHAN",
"name_prefix": "Mr.",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-21",
"last_updated": "2012-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "DE",
"license": "FI0000580",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dover, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2012; 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.