Individual provider Active NPI

Timothy J. Burkhart, DC

  • Chiropractor
  • Caledonia, MI
National Provider Identifier
1174598338
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301005013 Issued in MI
Practice address
7101 Broadmoor Ave SE
Caledonia, MI 49316-9510
Phone
(616) 698-0046
Fax
(616) 698-2188
NPI assigned
Feb 21, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301005013 MI Primary

Addresses

Primary practice location

7101 Broadmoor Ave SE
Caledonia, MI 49316-9510

Mailing address

7101 Broadmoor Ave SE
Caledonia, MI 49316-9510
Phone (616) 698-0046

Other identifiers 2

IdentifierTypeStateIssuer
649441OtherMIUNITED HEALTH CARE
TB005013OtherMIBCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100828000182 MI Practitioner - Chiropractic 6901897123 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Sherman College of Straight Chiropractic, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Burkhart Chiropractic PLCGroup PAC ID 9032161278, 3 clinicians

Practice addresses (Care Compare)

7101 Broadmoor Ave SE
Caledonia, MI 49316-7329
Phone (616) 698-0046

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Van Ryn Therapies CurrentSince Oct 2, 2022 Accepting new patients
Burkhart Chiropractic PLC Chiropractor CurrentSince May 5, 2003 Accepting new patients

Locations

7101 Broadmoor Ave SE
Caledonia, MI 49316
Phone (616) 330-0891

4649 N Breton Ct SE
Ste A
Kentwood, MI 49508
Phone (616) 275-0577

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": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174598338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7101 BROADMOOR AVE SE",
            "city": "CALEDONIA",
            "state": "MI",
            "postal_code": "493169510",
            "telephone_number": "616-698-0046",
            "fax_number": "616-698-2188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7101 BROADMOOR AVE SE",
            "city": "CALEDONIA",
            "state": "MI",
            "postal_code": "493169510",
            "telephone_number": "616-698-0046",
            "fax_number": "616-698-2188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURKHART",
        "first_name": "TIMOTHY",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301005013",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "649441",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "TB005013",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Caledonia, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.