Individual provider Active NPI

Brian Craig Burnett, D.C.

  • Chiropractor
  • Jacksonville Beach, FL
National Provider Identifier
1447510193
Registry record updated May 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH10679 Issued in FL
Practice address
320 1St St N
Suite 602
Jacksonville Beach, FL 32250-6944
Phone
(904) 270-2673
Fax
(904) 212-0024
NPI assigned
May 29, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH10679 FL Primary

Addresses

Primary practice location

320 1St St N
Suite 602
Jacksonville Beach, FL 32250-6944

Mailing address

320 1St St N
Suite 602
Jacksonville Beach, FL 32250-6944
Phone (904) 270-2673

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120703000448 FL Practitioner - Chiropractic 4486819125

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1338249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338249600000",
    "number": "1447510193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 1ST ST N",
            "address_2": "SUITE 602",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322506944",
            "telephone_number": "904-270-2673",
            "fax_number": "904-212-0024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 1ST ST N",
            "address_2": "SUITE 602",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322506944",
            "telephone_number": "904-270-2673",
            "fax_number": "904-212-0024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURNETT",
        "first_name": "BRIAN",
        "middle_name": "CRAIG",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-29",
        "last_updated": "2012-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH10679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2012; 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.