Individual provider Active NPI

Katherine Burtis, DC

  • Chiropractor
  • Deland, FL
National Provider Identifier
1659983716
Registry record updated Aug 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH13105 Issued in FL
Practice address
121 Victoria Commons Blvd Ste 106
Deland, FL 32724-7772
Phone
(386) 873-4787
NPI assigned
Aug 20, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH13105 FL Primary

Addresses

Primary practice location

121 Victoria Commons Blvd Ste 106
Deland, FL 32724-7772

Mailing address

121 Victoria Commons Blvd Ste 106
Deland, FL 32724-7772
Phone (386) 873-4787

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201007002839 FL Practitioner - Chiropractic 3072932227 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

121 Victoria Commons Blvd
Suite 106
Deland, FL 32724-7772
Phone (386) 473-5926

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH13105FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Pure Alignment Chiropractic PLLC Chiropractor CurrentSince Jun 11, 2020 Accepting new patients

Locations

121 Victoria Commons Blvd
Ste 106
Deland, FL 32724
Phone (386) 473-5926

Organizations & group practices 1

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": "1597881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597881600000",
    "number": "1659983716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 VICTORIA COMMONS BLVD STE 106",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327247772",
            "telephone_number": "386-873-4787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 VICTORIA COMMONS BLVD STE 106",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327247772",
            "telephone_number": "386-873-4787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURTIS",
        "first_name": "KATHERINE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-20",
        "last_updated": "2020-08-20",
        "certification_date": "2020-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH13105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Deland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2020; 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.