SPINE AND SPORTS INJURY CENTER, LLC (NPI# 1053690677) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053690677 |
| Entity Type | Organization |
| Organization Name | SPINE AND SPORTS INJURY CENTER, LLC |
| Practice Address |
1001 E Bogard Rd Wasilla AK 99654-7114 |
| Practice Telephone | 9073762225 |
| Practice Fax Number | 9073769225 |
| Mailing Telephone | 9073762225 |
| Mailing Fax Number | 9073769225 |
| Enumeration Date | 2011-08-12 |
| Last Update Date | 2011-08-12 |
| Authorized Official Name | DR. KRISTOFER D LARSON (OWNER) |
| Authorized Official Telephone | 9073769225 |
| Authorized Official Credential | D.C. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 225100000X | Physical Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| Y | 111NS0005X |
Chiropractor Specialization: Sports Physician |
435 | AK | Chiropractic Providers |
| Street Address |
1001 E BOGARD RD |
| City | WASILLA |
| State | AK |
| Zip Code | 99654-7114 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528030640 | Attila M Sipos | Chiropractor | 1001 E Bogard Rd, Wasilla, AK 99654-7114 | 2006-02-02 |
| 1821632282 | Candace Lynn Younts | Physical Medicine & Rehabilitation | 1001 E Bogard Rd, Wasilla, AK 99654-7114 | 2019-10-29 |
| 1912552795 | Briana Catherine Leatham | Physical Therapist | 1001 E Bogard Rd, Wasilla, AK 99654-7114 | 2019-08-07 |
| 1801176672 | Larson Chiropractic, LLC | Chiropractor | 1001 E Bogard Rd, Wasilla, AK 99654-7114 | 2011-08-24 |
| 1356621395 | Back In Action Physical Therapy, LLC | Physical Therapy Assistant | 1001 E Bogard Rd, Wasilla, AK 99654-7114 | 2011-08-23 |
| 1245461540 | Carolyn Margaret Black | Specialist/Technologist | 1001 E Bogard Rd, Wasilla, AK 99654-7114 | 2009-08-04 |
| 1982828281 | James Michael Hales | Physical Therapy Assistant | 1001 E Bogard Rd, Wasilla, AK 99654-7114 | 2007-04-11 |
| 1043388838 | Dr Daniel W Larson PC | Physical Therapist | 1001 E Bogard Rd, Wasilla, AK 99654-7114 | 2006-12-01 |
| 1417029976 | Kristofer Daniel Larson | Chiropractor | 1001 E Bogard Rd, Wasilla, AK 99654 | 2006-11-13 |
| 1497827950 | Daniel Werner Larson | Chiropractor | 1001 E Bogard Rd, Wasilla, AK 99654 | 2006-11-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003426784 | Colleen Maggie Newcity | Case Manager/Care Coordinator | 851 Westpoint Suite 310, Wasilla, AK 99654 | 2020-08-06 |
| 1659995884 | Amy M Lowe | Peer Specialist | 1363 W Spuce Ave, Wasilla, AK 99654 | 2020-06-03 |
| 1922648690 | Achieve Medical Alaska LLC | Clinic/Center | 1981 E Palmer, Suite 230, Wasilla, AK 99654 | 2020-01-10 |
| 1588205538 | Juan Carlos Garcia | Physician Assistant | 950 East Bogard Road, Suite 103, Wasilla, AK 99654 | 2019-10-01 |
| 1427610864 | Sharon Webb | Counselor | 705 S Knik Goose Bay Rd Suite K, Wasilla, AK 99654 | 2019-07-06 |
| 1306401864 | Logan Lee Cook | Peer Specialist | 2953 E Fairview Loop, Wasilla, AK 99654 | 2019-05-09 |
| 1053883595 | Moose Creek Medical Clinic LLC | Nurse Practitioner | 2341 S. Fern St., Suite 300, Wasilla, AK 99654 | 2018-12-21 |
| 1487124962 | Melissa A Stevens | Massage Therapist | 2201 W That Rd, Wasilla, AK 99654 | 2018-11-28 |
| 1609359561 | Audrey E Beers | Midwife | 2405 S. Knik Goose Bay Rd., Wasilla, AK 99654 | 2018-09-07 |
| 1093297418 | Karlee Janine Mccorry | Occupational Therapist | 613 S Knik-goose Bay Rd, Wasilla, AK 99654 | 2018-09-01 |
| Find all providers in zip 99654 | ||||
| Taxonomy Code | 111NS0005X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| Specialization | Sports Physician |
| A sports chiropractor is uniquely trained to provide care and treatment of injuries or illness resulting from sports and physical fitness activities. Doctors of Chiropractic with the Diplomate American Chiropractic Board of Sports Physicians (DACBSP) or the Certified Chiropractic Sports Physician (CCSP), sport specialty certifications from the American Chiropractic Board of Sports Physicians, have advanced training in the assessment, management and rehabilitation of sports related injuries. Extremity care, rehabilitation and soft tissue procedures are common skills utilized by these doctors. The specialty training covers a broad spectrum from the pediatric athlete to professional and Olympic athletes, and everything in between, using a variety of techniques and modalities. |
| Notes: Source: American Chiropractic Board of Sports Physicians, 2009 [7/1/2009: definition added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528030640 | Attila M Sipos | Chiropractor | 1001 E Bogard Rd, Wasilla, AK 99654-7114 | 2006-02-02 |
| 1417029976 | Kristofer Daniel Larson | Chiropractor | 1001 E Bogard Rd, Wasilla, AK 99654 | 2006-11-13 |
| 1396724951 | James D Martin | Chiropractor | 400 N Main St, Wasilla, AK 99654-7018 | 2006-01-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285918623 | Adams Chiropractic Health Clinic, LLC | Chiropractor | 3901 Old Seward Hwy, Suite 11, Anchorage, AK 99503-6089 | 2011-10-04 |
| 1831727445 | Alaska Pain To Wellness Centre LLC | Chiropractor | 2751 Debarr Rd Ste 310, Anchorage, AK 99508-6804 | 2020-03-30 |
| 1932417466 | Citycenterchiropractic Inc | Chiropractor | 800 Glacier Ave, Juneau, AK 99801-1855 | 2010-09-17 |
| 1326114984 | Birger I Baastrup | Chiropractor | 800 Glacier Ave, Juneau, AK 99801-1845 | 2006-11-27 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.