Organization Active NPI

Tifany a. Burckhard-Teets, DC-P.C.

  • Chiropractor
  • Minot, ND
National Provider Identifier
1528199387
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
690 Issued in ND
Legal business name
TIFANY A. BURCKHARD-TEETS, DC-P.C.
Practice address
1825 16TH St SW
Minot, ND 58701-6428
Phone
(701) 838-5000
Fax
(701) 852-1184
NPI assigned
Mar 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Tifany A Burckhard-Teets, DCNPI 1982762407
Title
Owner
Phone
(701) 838-5000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 690 ND Primary

Addresses

Primary practice location

1825 16TH St SW
Minot, ND 58701-6428

Mailing address

1825 16TH St SW
Minot, ND 58701-6428
Phone (701) 838-5000

Other identifiers 1

IdentifierTypeStateIssuer
02089001OtherNDBLUE CROSS BLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100112000265 ND Part B Supplier - Clinic/Group Practice 3274674353 Receives reassigned benefits from 1 practitioner
Practice locations: Minot, ND

National Provider Directory

National Provider Directory

Locations

1825 16th St SW
Minot, ND 58701
Phone (701) 838-1800

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1528199387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1825 16TH ST SW",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587016428",
            "telephone_number": "701-838-5000",
            "fax_number": "701-852-1184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1825 16TH ST SW",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587016428",
            "telephone_number": "701-838-5000",
            "fax_number": "701-852-1184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIFANY A. BURCKHARD-TEETS, DC-P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BURCKHARD-TEETS",
        "authorized_official_first_name": "TIFANY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "701-838-5000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "ND",
            "license": "690",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "02089001",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Minot, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.