Individual provider Active NPI

Tod Jason Burke, M.P.T.

  • Physical Therapist
  • Martinsburg, WV
National Provider Identifier
1689652836
Registry record updated Nov 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
002522 Issued in WV
Practice address
208 Old Mill Rd
Martinsburg, WV 25401-9219
Phone
(304) 671-9604
NPI assigned
Jan 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2022

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 002522 WV Primary

Addresses

Primary practice location

208 Old Mill Rd
Martinsburg, WV 25401-9219

Mailing address

108 Squaw Ter
Martinsburg, WV 25403-1294
Phone (304) 279-0109

Other practice location 1

108 Squaw Ter
Martinsburg, WV 25403-1294
Phone (304) 279-0109

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

LicenseStateTypeSpecialty
002522WVMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1136592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667952000000",
    "number": "1689652836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 SQUAW TER",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "254031294",
            "telephone_number": "304-279-0109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 OLD MILL RD",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "254019219",
            "telephone_number": "304-671-9604"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "108 Squaw Ter",
            "address_purpose": "LOCATION",
            "city": "Martinsburg",
            "state": "WV",
            "postal_code": "254031294",
            "country_code": "US",
            "telephone_number": "304-279-0109",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURKE",
        "first_name": "TOD",
        "middle_name": "JASON",
        "name_prefix": "Mr.",
        "credential": "M.P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-07",
        "last_updated": "2022-11-09",
        "certification_date": "2022-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WV",
            "license": "002522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Martinsburg, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2022; 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.