Individual provider Active NPI

Terry Lynn Burke, D.C., N.M.D.

  • Orthopedic Chiropractor
  • Idaho Falls, ID
National Provider Identifier
1386709806
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic ChiropractorTaxonomy code 111NX0800X
License
C792 Issued in ID
Practice address
1348 E 17TH St
Idaho Falls, ID 83404-6270
Phone
(208) 542-6564
Fax
(208) 542-6571
NPI assigned
Dec 26, 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
Orthopedic Chiropractor 111NX0800X C792 ID Primary

Addresses

Primary practice location

1348 E 17TH St
Idaho Falls, ID 83404-6270

Mailing address

1348 E 17TH St
Idaho Falls, ID 83404-6270
Phone (208) 542-6564

Other identifiers 1

IdentifierTypeStateIssuer
1740281435OtherIDINC NPI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080422000795 ID Practitioner - Chiropractic 1759469315 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C792IDMDOrthopedic Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Burke Family Chiropractic Integrative Health Services, Inc. Orthopedic CurrentSince Feb 21, 2003 Accepting new patients
Tedra Burke-Searls Chiropractic Professional Corporation Chiropractor PastSince Jan 1, 2020 Accepting new patients

Locations

1348 E 17th St
Idaho Falls, ID 83404
Phone (208) 542-6564

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": "1167091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386709806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1348 E 17TH ST",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834046270",
            "telephone_number": "208-542-6564",
            "fax_number": "208-542-6571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1348 E 17TH ST",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834046270",
            "telephone_number": "208-542-6564",
            "fax_number": "208-542-6571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURKE",
        "first_name": "TERRY",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "D.C., N.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NX0800X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Orthopedic",
            "state": "ID",
            "license": "C792",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INC NPI",
            "identifier": "1740281435",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Idaho Falls, ID

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

Verify at the official NPI Registry.