Individual provider Active NPI

John C. Burkholder, PHYSICAL THERAPIST

  • Physical Therapist
  • Corpus Christi, TX
National Provider Identifier
1417972043
Registry record updated Feb 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1129120 Issued in TX
Practice address
4040 Five Points Rd
Corpus Christi, TX 78410-4538
Phone
(361) 241-7399
Fax
(361) 241-7464
NPI assigned
Jul 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1129120 TX Primary

Addresses

Primary practice location

4040 Five Points Rd
Corpus Christi, TX 78410-4538

Mailing address

14241 Northwest Blvd
Ste 101
Corpus Christi, TX 78410-5545
Phone (361) 664-9675

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051228000404 TX Practitioner - Physical Therapist in Private Practice 6103848536 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1028 S 14TH St
Kingsville, TX 78363-6422
Phone (361) 488-6335

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Oliver Physical Therapy and Sports Medicine Centers Inc CurrentSince Feb 1, 2021 Accepting new patients

Locations

14241 Northwest Blvd
Ste 101
Corpus Christi, TX 78410
Phone (361) 933-0600

1028 S 14th St
Kingsville, TX 78363
Phone (361) 488-6335

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614038400000",
    "number": "1417972043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14241 NORTHWEST BLVD",
            "address_2": "STE 101",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784105545",
            "telephone_number": "361-664-9675",
            "fax_number": "361-664-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4040 FIVE POINTS RD",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784104538",
            "telephone_number": "361-241-7399",
            "fax_number": "361-241-7464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURKHOLDER",
        "first_name": "JOHN",
        "middle_name": "C.",
        "name_prefix": "Mr.",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2021-02-23",
        "certification_date": "2021-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1129120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corpus Christi, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 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.