Individual provider Active NPI

Kristen T Burke, D.C.

  • Chiropractor
  • Orange Park, FL
National Provider Identifier
1972683670
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH8049 Issued in FL
Practice address
1835 East West Parkway
Orange Park, FL 32003
Phone
(904) 264-3770
Fax
(904) 264-5885
NPI assigned
Oct 17, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH8049 FL Primary

Addresses

Primary practice location

1835 East West Parkway
Orange Park, FL 32003

Mailing address

1835 East West Parkway
Orange Park, FL 32003
Phone (904) 264-3770

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120118000102 FL Practitioner - Chiropractic 7911009360 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fleming Island Family ChiropracticGroup PAC ID 0749382190, 2 clinicians

Practice addresses (Care Compare)

1835 Eastwest Pkwy
Suite 3
Fleming Island, FL 32003-5310
Phone (904) 264-3770

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Fleming Island Family Chiropractic Chiropractor CurrentSince Apr 9, 2001 Accepting new patients

Locations

1835 Eastwest Pkwy
Orange Park, FL 32003
Phone (904) 215-3958

1835 Eastwest Pkwy
Ste 3
Orange Park, FL 32003
Phone (904) 264-3770

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.

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972683670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1835 EAST WEST PARKWAY",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "32003",
            "telephone_number": "904-264-3770",
            "fax_number": "904-264-5885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1835 EAST WEST PARKWAY",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "32003",
            "telephone_number": "904-264-3770",
            "fax_number": "904-264-5885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURKE",
        "first_name": "KRISTEN",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH8049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.