EASTPORT CHIROPRACTIC, LLC (NPI# 1396303822) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396303822 |
| Entity Type | Organization |
| Organization Name | EASTPORT CHIROPRACTIC, LLC |
| Other Organization Name | EASTPORT CHIROPRACTIC |
| Practice Address |
4025 Ne Lakewood Way Ste 100 Lees Summit MO 64064-2058 |
| Practice Telephone | 8165984363 |
| Practice Fax Number | 8167093074 |
| Mailing Telephone | 8165984363 |
| Mailing Fax Number | 8167093074 |
| Enumeration Date | 2019-05-30 |
| Last Update Date | 2019-12-10 |
| Authorized Official Name | SYRECE SHERMAN (OWNER) |
| Authorized Official Telephone | 8162776815 |
| Authorized Official Credential | DC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BLUE CROSS OF KANSAS CITY | 50218029 | 01 |
| Other Name | Type Code |
|---|---|
| Eastport Chiropractic | Doing Business As Name - Organization |
| Street Address |
4025 NE LAKEWOOD WAY STE 100 |
| City | LEES SUMMIT |
| State | MO |
| Zip Code | 64064-2058 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225647704 | James Andrew Kleoppel | Dentist | 3320 Ne Ralph Powell Rd., Lee's Summit, MO 64064 | 2020-07-30 |
| 1255991238 | Lee Summit Asc Kc LLC | Clinic/Center | 2861 Ne Independence Avenue, Suite 101, Lee's Summitt, MO 64064 | 2019-06-20 |
| 1073014676 | Sonya Renee Aversman | Dietitian, Registered | 3680 Ne Akin Dr, Suite 134, Lee's Summit, MO 64064 | 2018-02-28 |
| 1407398365 | Lakewood Chiropractic, P.C. | Chiropractor | 731 Ne Lakewood Boulevard, Lee's Summit, MO 64064 | 2016-11-09 |
| 1417403015 | Mikaela Groff | Dietitian, Registered | 401 Ne Grant Ct, Lee's Summit, MO 64064 | 2016-09-01 |
| 1952756405 | Sarah C. Vignery | Speech-Language Pathologist | 3600 Ne Ralph Powell Rd. Suite E, Lee's Summit, MO 64064 | 2016-05-03 |
| 1790146058 | Aneliya H Hristova | Physician Assistant | 3601 Ne Ralph Powell Road., Lee's Summit, MO 64064 | 2016-03-15 |
| 1821469982 | Alysse Barrett Doane | Nurse Practitioner | 2714 Ne Mcbaine Drive, Lees Summit, MO 64064 | 2015-10-15 |
| 1346638814 | Donna Thomas Dds, PC | Dentist | 3359 Ne Ralph Powell Rd, Lee's Summit, MO 64064 | 2015-01-06 |
| 1437579208 | Gregory Lohr | Dentist | 2931 Ne Independence Ave, Lees Summit, MO 64064 | 2014-04-21 |
| Find all providers in zip 64064 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982201455 | Maran Alexandra Tennis | Chiropractor | 211 Nw Executive Way Ste C, Lees Summit, MO 64063-1846 | 2020-10-07 |
| 1023639432 | Melissa Harrison | Chiropractor | 1057 Ne Queens Cir, Lees Summit, MO 64064-1771 | 2020-04-27 |
| 1538667050 | The Joint & Muscle Clinic of Missouri LLC | Chiropractor | 215 Sw Noel St, Lees Summit, MO 64063-2241 | 2018-01-30 |
| 1154873990 | Evexia Family Chiropractic, LLC | Chiropractor | 459 Sw Ward Rd, Lees Summit, MO 64081-2448 | 2016-10-27 |
| 1093262453 | Angela Segovia | Chiropractor | 338 Sw Main St, Lees Summit, MO 64063-2340 | 2016-09-02 |
| 1194278077 | Angela Imgarten | Chiropractor | 308 Ne Florence Ave, Lees Summit, MO 64063-2612 | 2016-07-27 |
| 1831551043 | Gregory Roger Davis | Chiropractor | 419a Sw Ward Rd, Lees Summit, MO 64081-2448 | 2016-03-26 |
| 1164896536 | Synergy Chiropractic LLC | Chiropractor | 603a Ne Woods Chapel Rd, Lees Summit, MO 64064-1900 | 2015-11-22 |
| 1447689849 | Curtis Reinkemeyer | Chiropractor | 410c Se 3rd St Ste 106, Lees Summit, MO 64063-2849 | 2013-11-06 |
| 1013271089 | Erica Roshell Simpson | Chiropractor | 506 Se 291 Hwy, Unit I, Lees Summit, MO 64063-4388 | 2012-06-25 |
| Find all providers in LEES SUMMIT | ||||
| City | LEES SUMMIT |
| Zip Code | 64064 |
Please comment or provide details below to improve the information on EASTPORT CHIROPRACTIC, LLC.
| 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.