Tyler Joseph Burke, DC

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

License

5657 Issued in OR

Practice address

2456 E Powell Blvd
Gresham, OR 97080-1311

Phone

(503) 298-9986

Fax

(503) 914-1496

NPI assigned

Aug 27, 2015

Last updated

Jul 12, 2020By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Amplife Chiropractic and Sports Chiropractic

  dba Amplife Chiropractic and Sports

  • Chiropractor
  • Gresham, OR
  • NPI 1922473719
  NPD (past) Authorized official

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

{
    "created_epoch": "1440633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594512000000",
    "number": "1487021234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16548 NE HALSEY ST APT 113",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972308612",
            "telephone_number": "208-340-1573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2456 E POWELL BLVD",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970801311",
            "telephone_number": "503-298-9986",
            "fax_number": "503-914-1496"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "811 SE 160th Ave",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986839655",
            "country_code": "US",
            "telephone_number": "503-298-9986",
            "fax_number": "503-914-1496",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURKE",
        "first_name": "TYLER",
        "middle_name": "JOSEPH",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-08-27",
        "last_updated": "2020-07-12",
        "certification_date": "2020-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "OR",
            "license": "5657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Building Resiliency LLC
• Joel A Bullard
• Gretchen C Burchell, FNP
• Regina Theresa Burck, QMHP
• Emily Burd, PNP
• Jacqueline Jane Burkhart, RDH
• Randall Joseph Burnett
• Cindy M Burns, QMHA-I
• Burnside Surgery Center LLC
• Aaron L Burrell, CADC-R

• Sports Physician Chiropractor in Gresham, OR
• Providers in Gresham, OR by specialty
• Sports Physician Chiropractor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 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.

Verify at the official NPI Registry.