Individual provider Active NPI

David Marshall Burgdorf, D.C.

  • Chiropractor
  • Weymouth, MA
National Provider Identifier
1952492142
Registry record updated Sep 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1612 Issued in MA
Practice address
317 Libbey Industrial Pkwy
Suite B-600
Weymouth, MA 02189-3113
Phone
(781) 337-4400
Fax
(781) 337-4480
NPI assigned
Sep 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 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 1612 MA Primary

Addresses

Primary practice location

317 Libbey Industrial Pkwy
Suite B-600
Weymouth, MA 02189-3113

Mailing address

317 Libbey Industrial Pkwy
Suite B-600
Weymouth, MA 02189-3113
Phone (781) 337-4400

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050315000291 MA Practitioner - Chiropractic 4385549195 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

317 Libbey Pkwy
Suite B600
Weymouth, MA 02189-3113
Phone (781) 337-4400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1612MAMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. David M. Burgdorf, D.C, Chiropractor CurrentSince Jun 19, 1991 Accepting new patients

Locations

293 Libbey Park
Ste A-100
Weymouth, MA 02189
Phone (339) 499-9237

317 Libbey Park
Ste B600
Weymouth, MA 02189
Phone (781) 337-4400

317 Libbey Park
Ste 600
Weymouth, MA 02189

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": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315526400000",
    "number": "1952492142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "317 LIBBEY INDUSTRIAL PKWY",
            "address_2": "SUITE B-600",
            "city": "WEYMOUTH",
            "state": "MA",
            "postal_code": "021893113",
            "telephone_number": "781-337-4400",
            "fax_number": "781-337-4480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 LIBBEY INDUSTRIAL PKWY",
            "address_2": "SUITE B-600",
            "city": "WEYMOUTH",
            "state": "MA",
            "postal_code": "021893113",
            "telephone_number": "781-337-4400",
            "fax_number": "781-337-4480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURGDORF",
        "first_name": "DAVID",
        "middle_name": "MARSHALL",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2011-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MA",
            "license": "1612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Weymouth, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2011; 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.