Jeremiah Luke Bursch, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

4107 Issued in MN

Practice address

12 2ND Ave S
Sauk Rapids, MN 56379-1408

Phone

(320) 257-6008

Fax

(320) 257-6009

NPI assigned

Dec 6, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Specialty

Chiropractic

Education

Northwestern College of Chiropractic, 2001

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Back to Health Acupuncture and Chiropractic Center, P.a.

  • Chiropractor
  • Sauk Rapids, MN
  • NPI 1043372204
  Medicare reassignment NPD Authorized official
• Hjort Chiropractic, P.a.

  • Chiropractor
  • Saint Cloud, MN
  • NPI 1104376169
  NPD (past)
• Hjort Chiropractic, P.a.

  • Chiropractor
  • Saint Cloud, MN
  • NPI 1467516088
  NPD (past)

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388361600000",
    "number": "1184783458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 2ND AVE S",
            "city": "SAUK RAPIDS",
            "state": "MN",
            "postal_code": "563791408",
            "telephone_number": "320-257-6008",
            "fax_number": "320-257-6009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 2ND AVE S",
            "city": "SAUK RAPIDS",
            "state": "MN",
            "postal_code": "563791408",
            "telephone_number": "320-257-6008",
            "fax_number": "320-257-6009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURSCH",
        "first_name": "JEREMIAH",
        "middle_name": "LUKE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-06",
        "last_updated": "2013-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "4107",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHIROCARE PROVIDER NUMBER",
            "identifier": "618536",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "235764000",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PROVIDE",
            "identifier": "P00119927",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "831S1BU",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Sauk Rapids, MN
• Providers in Sauk Rapids, MN by specialty
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2013; 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.