Taresa Mae Whittenburg, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

20036 Issued in CA

Practice address

1012 Carver Road
Modesto, CA 95350

Phone

(209) 549-2215

Fax

(209) 549-2216

NPI assigned

Oct 27, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Dr. Taresa Mae Joy Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Amber N. Kingsley D.C., Inc, a Chiropractic Corporation

  • Independent Medical Examiner Chiropractor
  • Modesto, CA
  • NPI 1386396018
  NPD (past)
• Rickie Edd Joy

  • Chiropractor
  • Modesto, CA
  • NPI 1912123514
  NPD (past)

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1316023914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1012 CARVER ROAD",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "95350",
            "telephone_number": "209-549-2215",
            "fax_number": "209-549-2216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1012 CARVER ROAD",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "95350",
            "telephone_number": "209-549-2215",
            "fax_number": "209-549-2216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITTENBURG",
        "first_name": "TARESA",
        "middle_name": "MAE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "20036",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA LIC",
            "identifier": "20036",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "BDC000520",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TARESA",
            "last_name": "JOY",
            "middle_name": "MAE",
            "prefix": "DR.",
            "credential": "DC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Kayla Jean Whitehead, MSW
• Elizabeth Whiteside
• Amy Whitlock
• Ronald T. Whitmore, MD
• Chaz Robert Whitsell
• Melissa Jean Whitworth
• Wichita Home Care Equipment, Inc.
• Charles Wickersham, PHARMD.
• Erika Marie Widergren
• David Wiebe, RN

• Chiropractor in Modesto, CA
• Providers in Modesto, CA by specialty
• Chiropractor in California

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.