Active NPI
Jack Neelan Burns Jr., D.C.
- Chiropractor
- San Pedro, CA
National Provider Identifier
1710272869
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 24301
- Practice address
- 1411 W 7TH St
Suite a
San Pedro, CA 90732-3522 - Phone
- (310) 831-5550
- Fax
- (310) 669-3094
- NPI assigned
- Jun 16, 2011
- 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 | 24301 | CA | Primary |
Addresses
Primary practice location
1411 W 7TH St
Suite a
San Pedro, CA 90732-3522
Mailing address
1411 W 7TH St
Suite a
San Pedro, CA 90732-3522
Phone (310) 831-5550
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 |
|---|---|---|---|
| 24301 | CA | MD | Certified Respiratory Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1308182400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1308182400000",
"number": "1710272869",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1411 W 7TH ST",
"address_2": "SUITE A",
"city": "SAN PEDRO",
"state": "CA",
"postal_code": "907323522",
"telephone_number": "310-831-5550",
"fax_number": "310-669-3094"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1411 W 7TH ST",
"address_2": "SUITE A",
"city": "SAN PEDRO",
"state": "CA",
"postal_code": "907323522",
"telephone_number": "310-831-5550",
"fax_number": "310-669-3094"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURNS",
"first_name": "JACK",
"middle_name": "NEELAN",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-06-16",
"last_updated": "2011-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "24301",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Pedro, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 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.