Active NPI
Burt Clinic of Chiropractic PC
- Chiropractor
- Walcott, IA
National Provider Identifier
1932249869
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 04377
- Legal business name
- BURT CLINIC OF CHIROPRACTIC PC
- Practice address
- 790 N Main St
Walcott, IA 52773-9505 - Phone
- (563) 284-6927
- Fax
- (563) 284-6398
- NPI assigned
- Feb 8, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mickey Burt, DC
- Title
- Owner Operator
- Phone
- (563) 284-6927
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 04377 | IA | Primary |
Addresses
Primary practice location
790 N Main St
Walcott, IA 52773-9505
Mailing address
PO Box 790
790 N Main St
Walcott, IA 52773-0790
Phone (563) 284-6927
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0122689 | Medicaid | IA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040322000516 | IA | Part B Supplier - Clinic/Group Practice | 6507757473 |
Receives reassigned benefits from 4 practitioners Practice locations: Walcott, IA |
National Provider Directory
National Provider DirectoryLocations
790 N Main St
Walcott, IA 52773
Phone (319) 284-6927
Practitioners 4
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Chiropractor
- Walcott, IA
- NPI 1477807071
-
- Chiropractor
- Walcott, IA
- NPI 1689646416
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170892800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1357776000000",
"number": "1932249869",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 790",
"address_2": "790 N MAIN ST",
"city": "WALCOTT",
"state": "IA",
"postal_code": "527730790",
"telephone_number": "563-284-6927",
"fax_number": "563-284-6398"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "790 N MAIN ST",
"city": "WALCOTT",
"state": "IA",
"postal_code": "527739505",
"telephone_number": "563-284-6927",
"fax_number": "563-284-6398"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BURT CLINIC OF CHIROPRACTIC PC",
"organizational_subpart": "NO",
"enumeration_date": "2007-02-08",
"last_updated": "2013-01-10",
"status": "A",
"authorized_official_last_name": "BURT",
"authorized_official_first_name": "MICKEY",
"authorized_official_title_or_position": "OWNER OPERATOR",
"authorized_official_telephone_number": "563-284-6927",
"authorized_official_credential": "DC"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Chiropractor",
"state": "IA",
"license": "04377",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0122689",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Walcott, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2013; 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.