Stephen Kyle Burtenshaw, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CHIA-1159 Issued in ID

Practice address

757 E Wythe Creek CT Ste 102
Kuna, ID 83634-5006

Phone

(208) 922-4908

Fax

(208) 922-4909

NPI assigned

Aug 3, 2006

Last updated

Sep 29, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Specialty

Chiropractic

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pioneer Sports and Pain Center LLCGroup PAC ID 8325263379, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Pioneer Sports & Pain Center LLC

  • Rehabilitation Chiropractor
  • Kuna, ID
  • NPI 1598068280
  Medicare reassignment Care Compare group Authorized official
• Boise Spine & Orthopedic Bracing, LLC

  • Durable Medical Equipment & Medical Supplies
  • Kuna, ID
  • NPI 1386188548
  NPD Authorized official

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632873600000",
    "number": "1386652691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "757 E WYTHE CREEK CT STE 102",
            "city": "KUNA",
            "state": "ID",
            "postal_code": "836345006",
            "telephone_number": "208-922-4908",
            "fax_number": "208-922-4909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "757 E WYTHE CREEK CT STE 102",
            "city": "KUNA",
            "state": "ID",
            "postal_code": "836345006",
            "telephone_number": "208-922-4908",
            "fax_number": "208-922-4909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURTENSHAW",
        "first_name": "STEPHEN",
        "middle_name": "KYLE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-03",
        "last_updated": "2021-09-29",
        "certification_date": "2021-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ID",
            "license": "CHIA-1159",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807407200",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erika Brady, PA-C
• Jennifer Brazee, OTR/L
• Brigham Murray Anesthesia LLC
• Colin Brown, PA-C
• Carolyn Jane Bryden, M.A.T.
• Susan Diane Cane, LMFT
• Courtland Reid Carbol, MD
• Charles Golightly
• Clarifeye, PC
• Sally Anderson Cleary, LPC

• Chiropractor in Kuna, ID
• Providers in Kuna, ID by specialty
• Chiropractor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 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.