Active NPI
Dean Ralph Burkholder, DC
- Sports Physician Chiropractor
- Shippensburg, PA
National Provider Identifier
1396744462
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Physician Chiropractor
- License
- DC001937L, CERT #73
- Practice address
- 9318 Molly Pitcher Hwy
Shippensburg, PA 17257-9205 - Phone
- (717) 532-8873
- Fax
- (717) 532-3845
- NPI assigned
- Jul 20, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | DC001937L | PA | |
| Sports Physician Chiropractor | 111NS0005X | DC001937L, CERT #73 | PA | Primary |
Addresses
Primary practice location
9318 Molly Pitcher Hwy
Shippensburg, PA 17257-9205
Mailing address
9318 Molly Pitcher Hwy
Shippensburg, PA 17257-9205
Phone (717) 532-8873
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 287165 | Other | MAMSI | |
| 0006213800003 | Medicaid | PA | |
| 555345 | Other | AETNA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DC001937L, CERT #73 | PA | MD | Sports Physician Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121817600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1268956800000",
"number": "1396744462",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9318 MOLLY PITCHER HWY",
"city": "SHIPPENSBURG",
"state": "PA",
"postal_code": "172579205",
"telephone_number": "717-532-8873",
"fax_number": "717-532-3845"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9318 MOLLY PITCHER HWY",
"city": "SHIPPENSBURG",
"state": "PA",
"postal_code": "172579205",
"telephone_number": "717-532-8873",
"fax_number": "717-532-3845"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURKHOLDER",
"first_name": "DEAN",
"middle_name": "RALPH",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-07-20",
"last_updated": "2010-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "PA",
"license": "DC001937L",
"primary": false
},
{
"code": "111NS0005X",
"taxonomy_group": "",
"desc": "Chiropractor, Sports Physician",
"state": "PA",
"license": "DC001937L, CERT #73",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAMSI",
"identifier": "287165",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0006213800003",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "555345",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Shippensburg, PA
- Jennifer Jane Britcher, LSW
- Misty Autumn Brown, MIDWIFE
- Karen Frances Bryson, M.D.
- Tracey Buchheister, PA-C
- Elizabeth Karen Budny, PA-C
- Cable Eye Associates, LLC
- Vincent A Cantone, M.D.
- Sean Michael Carver, LAT, ATC, NASM-PES
- CFCS, LLC (Cumberland-Franklin Counseling Services)
- Children'S Community Care (Children's Community Pediatrics)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.