Individual provider Active NPI

Lyle Robert Burkhardt, DC

  • Chiropractor
  • Pensacola, FL
National Provider Identifier
1316357775
Registry record updated Feb 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH11196 Issued in FL
Practice address
2921 W Michigan Ave
Pensacola, FL 32526-1845
Phone
(850) 434-8880
NPI assigned
May 6, 2014
Last updated
Feb 17, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1742 LA
Chiropractor 111N00000X CH11196 FL Primary

Addresses

Primary practice location

2921 W Michigan Ave
Pensacola, FL 32526-1845

Mailing address

2921 W Michigan Ave
Pensacola, FL 32526-1845
Phone (850) 434-8880

Other practice location 1

24 E Nine Mile Rd
Pensacola, FL 32534-3137
Phone (850) 479-1333

Other practice location 2

24 E Nine Mile Rd
Pensacola, FL 32534-3137
Phone (850) 479-1333

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140522001135 FL Practitioner - Chiropractic 9739302662 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2921 W Michigan Ave
Pensacola, FL 32526-1845
Phone (850) 434-8880

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH11196FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Spinal Centers Inc CurrentSince Jan 13, 2021 Accepting new patients
Bernard J Keenum DC Inc PastSince Jan 13, 2021 Accepting new patients

Locations

24 E Nine Mile Rd
Pensacola, FL 32534
Phone (850) 479-1333

2921 W Michigan Ave
Pensacola, FL 32526
Phone (850) 434-8880

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": "1399334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613520000000",
    "number": "1316357775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2921 W MICHIGAN AVE",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325261845",
            "telephone_number": "850-434-8880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2921 W MICHIGAN AVE",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325261845",
            "telephone_number": "850-434-8880"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "24 E Nine Mile Rd",
            "address_purpose": "LOCATION",
            "city": "Pensacola",
            "state": "FL",
            "postal_code": "325343137",
            "country_code": "US",
            "telephone_number": "850-479-1333",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "24 E Nine Mile Rd",
            "address_purpose": "LOCATION",
            "city": "Pensacola",
            "state": "FL",
            "postal_code": "325343137",
            "country_code": "US",
            "telephone_number": "850-479-1333",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURKHARDT",
        "first_name": "LYLE",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-06",
        "last_updated": "2021-02-17",
        "certification_date": "2021-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "LA",
            "license": "1742",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH11196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2021; 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.