Active NPI
Ronald Lee Burgess II, DC, ND
- Chiropractor
- Port Orange, FL
National Provider Identifier
1598480295
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 14226
- Practice address
- 633 Dunlawton Ave
Port Orange, FL 32127-4342 - Phone
- (386) 366-7418
- NPI assigned
- Oct 5, 2022
- Sex
- Male
- Sole proprietor
- No
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 | 14226 | FL | Primary |
Addresses
Primary practice location
633 Dunlawton Ave
Port Orange, FL 32127-4342
Mailing address
1789 S Clyde Morris Blvd Apt 203
Daytona Beach, FL 32119-9027
Phone (330) 603-2988
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14226 | FL | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1664928000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1664928000000",
"number": "1598480295",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1789 S CLYDE MORRIS BLVD APT 203",
"city": "DAYTONA BEACH",
"state": "FL",
"postal_code": "321199027",
"telephone_number": "330-603-2988"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "633 DUNLAWTON AVE",
"city": "PORT ORANGE",
"state": "FL",
"postal_code": "321274342",
"telephone_number": "386-366-7418"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURGESS",
"first_name": "RONALD",
"middle_name": "LEE",
"name_prefix": "Dr.",
"name_suffix": "II",
"credential": "DC, ND",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-10-05",
"last_updated": "2022-10-05",
"certification_date": "2022-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "FL",
"license": "14226",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Orange, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.