Individual provider Active NPI

Douglas S Burson, DC

  • Chiropractor
  • Broomfield, CO
National Provider Identifier
1215922141
Registry record updated Apr 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHR.0006980 Issued in CO
Practice address
520 Zang St Ste 250
Broomfield, CO 80021-8347
Phone
(303) 214-7907
Fax
(720) 925-5897
NPI assigned
Sep 16, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 23, 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 3617012 WI
Chiropractor 111N00000X CHR.0006980 CO Primary

Addresses

Primary practice location

520 Zang St Ste 250
Broomfield, CO 80021-8347

Mailing address

5445 DTC Pkwy Ste 1130
Greenwood Village, CO 80111-3038
Phone (720) 749-5599

Other practice location 1

11649 N Port Washington Rd
Suite 100
Mequon, WI 53092-3460
Phone (262) 240-2273

Other identifiers 1

IdentifierTypeStateIssuer
38933100MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220927002518 CO Practitioner - Chiropractic 5890778856 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mountain View Pain CenterGroup PAC ID 1052469152, 61 clinicians

Practice addresses (Care Compare)

520 Zang St
Suite 250
Broomfield, CO 80021-8347
Phone (303) 214-7907

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3617012WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain View Pain Center Chiropractor CurrentSince Mar 24, 2024 Accepting new patients
Allied Health of Wisconsin, SC Chiropractor Past Accepting new patients
Lickteig Chiropractic Clinic,S.C. Chiropractor PastSince Sep 1, 2005 Accepting new patients

Locations

520 Zang St
Ste 250
Broomfield, CO 80021
Phone (303) 214-7907

63 N Quebec St
Ste 300
Denver, CO 80230
Phone (720) 798-2811

5445 Dtc Pkwy
Ste 1130
Greenwood Village, CO 80111

300 Exempla Cir
Ste 130
Lafayette, CO 80026
Phone (303) 539-2533

5920 S Estes St
Ste 220
Littleton, CO 80123
Phone (303) 221-1569

Organizations & group practices 3

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": "1126828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713830400000",
    "number": "1215922141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5445 DTC PKWY STE 1130",
            "city": "GREENWOOD VILLAGE",
            "state": "CO",
            "postal_code": "801113038",
            "telephone_number": "720-749-5599",
            "fax_number": "720-925-5897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 ZANG ST STE 250",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800218347",
            "telephone_number": "303-214-7907",
            "fax_number": "720-925-5897"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11649 N Port Washington Rd",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Mequon",
            "state": "WI",
            "postal_code": "530923460",
            "country_code": "US",
            "telephone_number": "262-240-2273",
            "fax_number": "262-240-2260",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURSON",
        "first_name": "DOUGLAS",
        "middle_name": "S",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-16",
        "last_updated": "2024-04-23",
        "certification_date": "2024-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "3617012",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "CHR.0006980",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38933100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Broomfield, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 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.