Active NPI
Tyler Burke, DPT
- Physical Therapist
- Idaho Falls, ID
National Provider Identifier
1427464502
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT-3529
- Practice address
- 3100 Channing Way
Idaho Falls, ID 83404-7533 - Phone
- (208) 529-7665
- NPI assigned
- Jul 9, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT-3529 | ID | Primary |
Addresses
Primary practice location
3100 Channing Way
Idaho Falls, ID 83404-7533
Mailing address
6700 Antioch Rd Ste 120
Merriam, KS 66204-1200
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT-3529 | ID | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Idaho Direct Physical Therapy, PLLC | Current | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Physical Therapy Clinic/Center
- Idaho Falls, ID
- NPI 1518560671
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1404864000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603411200000",
"number": "1427464502",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6700 ANTIOCH RD STE 120",
"city": "MERRIAM",
"state": "KS",
"postal_code": "662041200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3100 CHANNING WAY",
"city": "IDAHO FALLS",
"state": "ID",
"postal_code": "834047533",
"telephone_number": "208-529-7665"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURKE",
"first_name": "TYLER",
"name_prefix": "Dr.",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-07-09",
"last_updated": "2020-10-23",
"certification_date": "2020-10-23",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "ID",
"license": "PT-3529",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Idaho Falls, ID
- Sherri Lyn Burgener, M.S., CCC-SLP
- Lisa Marie Burger, ACAGNP-C
- Terrell Burgess, BA
- Burke Family Chiropractic Integrative Health Services, Inc.
- Terry Lynn Burke, D.C., N.M.D.
- Burn and Reconstructive Centers of Idaho, PLLC
- Robert Stephen Burns, LMT
- Neil K Burraston, DO
- Bryce A. Burtenshaw, DDS
- Kathryn Burton, PHARMD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.