Individual provider Active NPI

Tedra L Burke-Searls, D.C.

  • Chiropractor
  • Lodi, CA
National Provider Identifier
1104844828
Registry record updated Dec 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC24095 Issued in CA
Practice address
1822 W Kettleman LN Ste 5
Lodi, CA 95242-4218
Phone
(209) 334-2841
Fax
(209) 334-2307
NPI assigned
Jul 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC24095 CA Primary
Chiropractor 111N00000X CHIA-1769 ID

Addresses

Primary practice location

1822 W Kettleman LN Ste 5
Lodi, CA 95242-4218

Mailing address

1822 W Kettleman LN Ste 5
Lodi, CA 95242-4218
Phone (209) 334-2841

Other practice location 1

755 S Fairmont Ave Ste C
Lodi, CA 95240-4643
Phone (209) 334-2841

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051216000738 CA Practitioner - Chiropractic 9739100751 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1822 W Kettleman LN
Suite 5
Lodi, CA 95242-4218
Phone (209) 334-2841

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC24095CAMDChiropractor
CHIA-1769IDMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Tedra Burke-Searls Chiropractic, Inc. Chiropractor CurrentSince Nov 1, 2005 Accepting new patients
Burke Family Chiropractic Integrative Health Services, Inc. PastSince Jan 1, 2020 Accepting new patients

Locations

755 S Fairmont Ave
Ste C
Lodi, CA 95240
Phone (209) 334-2841

1822 W Kettleman Ln
Ste 5
Lodi, CA 95242
Phone (209) 334-2841

531 W Kettleman Ln
Lodi, CA 95240
Phone (209) 334-2841

Organizations & group practices 2

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": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576540800000",
    "number": "1104844828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1822 W KETTLEMAN LN STE 5",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952424218",
            "telephone_number": "209-334-2841",
            "fax_number": "209-334-2307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1822 W KETTLEMAN LN STE 5",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952424218",
            "telephone_number": "209-334-2841",
            "fax_number": "209-334-2307"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "755 S Fairmont Ave Ste C",
            "address_purpose": "LOCATION",
            "city": "Lodi",
            "state": "CA",
            "postal_code": "952404643",
            "country_code": "US",
            "telephone_number": "209-334-2841",
            "fax_number": "209-334-2307",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURKE-SEARLS",
        "first_name": "TEDRA",
        "middle_name": "L",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-18",
        "last_updated": "2019-12-17",
        "certification_date": "2019-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC24095",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ID",
            "license": "CHIA-1769",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lodi, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2019; 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.