Michael T Burcon, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2301007711 Issued in MI

Practice address

3501 Lake Eastbrook Blvd SE
Suite 252
Grand Rapids, MI 49546-5938

Phone

(616) 575-9990

Fax

(616) 575-9995

NPI assigned

Jun 28, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1119916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364169600000",
    "number": "1992702542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3501 LAKE EASTBROOK BLVD SE",
            "address_2": "SUITE 252",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495465938",
            "telephone_number": "616-575-9990",
            "fax_number": "616-575-9995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 LAKE EASTBROOK BLVD SE",
            "address_2": "SUITE 252",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495465938",
            "telephone_number": "616-575-9990",
            "fax_number": "616-575-9995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURCON",
        "first_name": "MICHAEL",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-28",
        "last_updated": "2013-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301007711",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "950D151480",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4126753",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Caleb Patrick Bupp, MD
• Ashley Burch, RN
• Cynthia Ruth Lanning Burch, LLMSW
• Megan Diane Burcham
• Gretchen Elizabeth Burchi, LMT
• Emily Burden, LLMSW
• David Edwin Burdette, MD
• Erin Desiree Burdi, NP
• Nicole Burdick, M.A. CCC-SLP
• Stephanie Burdick, MD

• Chiropractor in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Chiropractor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 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.

Verify at the official NPI Registry.