OMAHA SPINE AND SPORT, FUNCTIONAL CHIROPRACTIC CENTER, PC (NPI# 1407115488) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407115488 |
| Entity Type | Organization |
| Organization Name | OMAHA SPINE AND SPORT, FUNCTIONAL CHIROPRACTIC CENTER, PC |
| Practice Address |
15615 Pacific St Ste 106 Omaha NE 68118-2118 |
| Practice Telephone | 4029334447 |
| Practice Fax Number | 4029334857 |
| Mailing Telephone | 4029334447 |
| Mailing Fax Number | 4029334857 |
| Enumeration Date | 2012-05-10 |
| Last Update Date | 2012-05-23 |
| Authorized Official Name | DR. COREY J CAMPBELL (CHIROPRACTOR/PRESIDENT) |
| Authorized Official Telephone | 4029334447 |
| Authorized Official Credential | DC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 1328 | NE | Chiropractic Providers |
| Street Address |
15615 PACIFIC ST STE 106 |
| City | OMAHA |
| State | NE |
| Zip Code | 68118-2118 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215416888 | Elevate Chiropractic LLC | Chiropractor | 15615 Pacific St Ste 106, Omaha, NE 68118-2187 | 2018-08-14 |
| 1295246791 | Omne Chiropractic LLC | Chiropractor | 15615 Pacific St Ste 106, Omaha, NE 68118-2187 | 2017-10-24 |
| 1346761871 | Blake Barry | Chiropractor | 15615 Pacific St Ste 106, Omaha, NE 68118-2187 | 2017-07-06 |
| 1811395528 | Allison R Blessing | Chiropractor | 15615 Pacific St Ste 106, Omaha, NE 68118-2187 | 2014-12-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932644127 | Renal Care Group of The Midwest, Inc. | Clinic/Center | 15801 West Dodge Road, Omaha, NE 68118 | 2016-12-27 |
| 1982091583 | Andrew Siref | Student in an Organized Health Care Education/Training Program | 16622 Howard Cir, Omaha, NE 68118 | 2015-04-21 |
| 1942628839 | Deirdre Anne Stolmeier | Dermatology | 515 N 162nd Ave Ste 302, Omaha, NE 68118 | 2014-03-28 |
| 1457625782 | James Clark | Pharmacist | 16130 Parker St, Omaha, NE 68118 | 2012-03-05 |
| 1619102613 | Children's West Village Pointe - Diagnostic Services | Spec/Tech, Pathology | 110 North 175 Street, Children's West Village Pointe - Diagnostic Services, Omaha, NE 68118 | 2009-05-19 |
| 1033359732 | Children's Hospital | Pediatrics | 110 North 175 Street, Suite 1000, Children's Hospital - Urgent Care - West Village Pointe, Omaha, NE 68118 | 2009-02-20 |
| 1285802538 | Becker Chiropractic LLC | Chiropractor | 17785 Mason St, Suite 101, Omaha, NE 68118 | 2008-02-20 |
| 1598940611 | Dane Patrick Becker | Chiropractor | 17785 Mason St., Suite 101, Omaha, NE 68118 | 2008-01-08 |
| 1700951779 | Karoline S Anderson | Pediatrics | 16811 Burke Street, Ste 101, Omaha, NE 68118 | 2006-11-22 |
| 1154435691 | Scott M Debates | Dermatology | 515 N 162nd Avennue, Ste. 302, Omaha, NE 68118 | 2006-08-19 |
| Find all providers in zip 68118 | ||||
| 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 |
|---|---|---|---|---|
| 1932713674 | Dalton Sealey | Chiropractor | 4638 Dodge St, Omaha, NE 68132-3234 | 2020-09-01 |
| 1154935807 | Bruce Eshelman | Chiropractor | 909 Capitol Ave Apt 507, Omaha, NE 68102-1295 | 2020-09-01 |
| 1154965473 | Cassandra Thielen | Chiropractor | 18010 R Plz Ste 104, Omaha, NE 68135-1923 | 2019-10-30 |
| 1619539012 | Abundance Chiropractic, LLC | Chiropractor | 18111 Q St Ste 104, Omaha, NE 68135-1245 | 2019-07-05 |
| 1083275317 | Tara Carlson | Chiropractor | 3808 S 203rd Plz Ste 400, Omaha, NE 68130-6402 | 2019-06-26 |
| 1144791658 | Klink Chiropractic & Acupuncture, PC | Chiropractor | 2527 S 140th Ave, Omaha, NE 68144-2301 | 2018-12-10 |
| 1881165397 | Elle Klink | Chiropractor | 2527 S 140th Street, Omaha, NE 68144 | 2018-12-10 |
| 1497239560 | Sarpy Chiropractic Millard | Chiropractor | 4909 S 135th St Ste 104, Omaha, NE 68137-1657 | 2018-09-24 |
| 1962904334 | Louis Nutter | Chiropractor | 14450 Meadows Blvd, Omaha, NE 68138-3896 | 2018-03-01 |
| 1073021796 | Derek Virgl | Chiropractor | 17785 Mason St Ste 101, Omaha, NE 68118-3526 | 2018-01-16 |
| Find all providers in OMAHA | ||||
Please comment or provide details below to improve the information on OMAHA SPINE AND SPORT, FUNCTIONAL CHIROPRACTIC CENTER, PC.
| 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.