Individual provider Active NPI

Bradley Richard Verburg, D.C.

  • Chiropractor
  • East Lansing, MI
National Provider Identifier
1689971277
Registry record updated Feb 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301009779 Issued in MI
Practice address
4500 S Hagadorn Rd
East Lansing, MI 48823-6813
Phone
(517) 324-5433
Fax
(517) 324-9594
NPI assigned
Feb 17, 2011
Last updated
Feb 17, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301009779 MI Primary

Addresses

Primary practice location

4500 S Hagadorn Rd
East Lansing, MI 48823-6813

Mailing address

4500 S Hagadorn Rd
East Lansing, MI 48823-6813
Phone (517) 324-5433

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
2301009779MIMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1297900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297900800000",
    "number": "1689971277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 S HAGADORN RD",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488236813",
            "telephone_number": "517-324-5433",
            "fax_number": "517-324-9594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 S HAGADORN RD",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488236813",
            "telephone_number": "517-324-5433",
            "fax_number": "517-324-9594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERBURG",
        "first_name": "BRADLEY",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-02-17",
        "last_updated": "2011-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301009779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Lansing, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.