Individual provider Active NPI

Lynne Marie Butner, DC

  • Chiropractor
  • Modesto, CA
National Provider Identifier
1154309920
Registry record updated Jun 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC 15778 Issued in CA
Practice address
2801 Coffee Rd
A-1
Modesto, CA 95355-1756
Phone
(209) 524-7796
Fax
(209) 524-8477
NPI assigned
Jan 3, 2006
Last updated
Jun 3, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC 15778 CA Primary

Addresses

Primary practice location

2801 Coffee Rd
A-1
Modesto, CA 95355-1756

Mailing address

2801 Coffee Rd
A-1
Modesto, CA 95355-1756
Phone (209) 524-7796

Other names 1

  • Lynne Marie Jertberg Former name

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
15778CAMDMental Health Counselor
DC 15778CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Ronald J. Mostowski,Chiropractic, Inc. Chiropractor PastSince Jul 31, 2006 Accepting new patients
Early Chiropractic Corporation Chiropractor Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1136246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433289600000",
    "number": "1154309920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 COFFEE RD",
            "address_2": "A-1",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953551756",
            "telephone_number": "209-524-7796",
            "fax_number": "209-524-8477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 COFFEE RD",
            "address_2": "A-1",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953551756",
            "telephone_number": "209-524-7796",
            "fax_number": "209-524-8477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTNER",
        "first_name": "LYNNE",
        "middle_name": "MARIE",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-01-03",
        "last_updated": "2015-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC 15778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LYNNE",
            "last_name": "JERTBERG",
            "middle_name": "MARIE",
            "credential": "DC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Modesto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.