SPINE & SPORTS INJURY CENTER, P.C. (NPI# 1649479395) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649479395 |
| Entity Type | Organization |
| Organization Name | SPINE & SPORTS INJURY CENTER, P.C. |
| Practice Address |
4 Avery St 4th Floor Boston MA 02111-1005 |
| Mailing Address |
2 Avery St 27f Boston MA 02111-1002 |
| Practice Telephone | 6173758580 |
| Practice Fax Number | 8572334487 |
| Mailing Telephone | 8572334487 |
| Mailing Fax Number | 8572334487 |
| Enumeration Date | 2007-07-13 |
| Last Update Date | 2007-11-19 |
| Authorized Official Name | DR. RICHARD LAWRENCE GREEN (PRESIDENT) |
| Authorized Official Telephone | 8572334487 |
| Authorized Official Credential | DC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
966 | MA | Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891840922 | Spine & Sports Injury Center, P.C. | Chiropractor | 4 Avery St, Boston, MA 02111-1005 | 2007-01-25 |
| Street Address |
4 AVERY ST 4TH FLOOR |
| City | BOSTON |
| State | MA |
| Zip Code | 02111-1005 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134219041 | Richard Lawrence Green | Chiropractor | 4 Avery St, 4th Floor, Boston, MA 02111-1005 | 2006-10-13 |
| 1427572668 | Christopher Gerald Rudnick | Physical Therapist | 4 Avery St, Boston, MA 02111-1005 | 2017-07-31 |
| 1033586375 | Allison Leigh Nichols | Physical Therapist | 4 Avery St, 4th Floor, Boston, MA 02111-1005 | 2015-08-21 |
| 1710363858 | Stephanie Samson | Physical Therapist | 4 Avery St, 4th Floor, Boston, MA 02111-1005 | 2015-07-30 |
| 1104181650 | Stefanie Ann Rousselle | Physical Therapist | 4 Avery St, Boston, MA 02111-1005 | 2012-07-11 |
| 1003189234 | Kelley Morgan | Physical Therapist | 4 Avery St, Boston, MA 02111-1005 | 2012-02-19 |
| 1891840922 | Spine & Sports Injury Center, P.C. | Chiropractor | 4 Avery St, Boston, MA 02111-1005 | 2007-01-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689271397 | Maximilian Richert | Counselor | 25 Kingston St, 4r, Boston, MA 02111 | 2020-10-06 |
| 1558978957 | Tien-hsin Chang | Student in an Organized Health Care Education/Training Program | 1 Kneeland Street (tufts University School of Dental Me, Boston, MA 02111 | 2020-09-29 |
| 1548883465 | Elizabeth Carter Stapleton | Dentist | Tufts School of Dental Medicine: Dept of Orthodontics, 1 Kneeland Street, Boston, MA 02111 | 2020-05-27 |
| 1932729597 | Jacob Joseph Kosarchuk | Neurological Surgery | 800 Washington Street, Proger 7, Boston, MA 02111 | 2020-04-23 |
| 1164051868 | Daniele Abela | Surgery | 860 Washington Street, South Building, 4th Floor, Boston, MA 02111 | 2020-04-04 |
| 1184265258 | Jade Orthodontics | Dentist | 30 Kneeland St, Suite 301, Boston, MA 02111 | 2019-09-30 |
| 1932753639 | Loukia Kamille Danaf | Student in an Organized Health Care Education/Training Program | 1 Kneeland Street, Tufts University School of Dental Me, Boston, MA 02111 | 2019-07-31 |
| 1033771944 | Faris Khalifa | Student in an Organized Health Care Education/Training Program | 1 Kneeland Street, 5th Floor, Boston, MA 02111 | 2019-07-01 |
| 1609437276 | Blair Hanna Ray Farbstein | Student in an Organized Health Care Education/Training Program | 1 Kneeland Street, 3rd Floor, Boston, MA 02111 | 2019-06-25 |
| 1821658709 | Jennifer Drummond | Internal Medicine | 800 Washington St. Gme Office, Boston, MA 02111 | 2019-06-13 |
| Find all providers in zip 02111 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952938839 | Jessica Moy Wellness LLC | Clinic/Center | 255 Massachusetts Ave Apt 204, Boston, MA 02115-3511 | 2020-03-23 |
| 1598390940 | The Method Performance and Physical Therapy LLC | Clinic/Center | 378 North St Apt 2, Boston, MA 02113-2143 | 2020-03-05 |
| 1316585482 | Healthworks Med Group of Massachusetts P C | Clinic/Center | 157 Berkeley St, Boston, MA 02116-5108 | 2019-12-19 |
| 1871149583 | Shalom Physical Therapy, LLC | Clinic/Center | 78 Bennington St, Boston, MA 02128-1704 | 2019-08-18 |
| 1992205868 | Maximize Your Mobility LLC | Clinic/Center | 292 Newbury St Ste 317, Boston, MA 02115-2801 | 2018-02-17 |
| 1144745902 | Sustained Fitness LLC | Clinic/Center | 581 Boylston St Ste 404, Boston, MA 02116-3624 | 2017-08-13 |
| 1407395916 | District Physical Therapy & Wellness | Clinic/Center | 9 Earl St, Boston, MA 02127-2532 | 2017-02-16 |
| 1366685257 | Mullis and Associates Physical Therapy, Inc. | Clinic/Center | 811 Massachusetts Ave, Suite 100, Boston, MA 02118-2605 | 2009-04-08 |
| 1235763327 | Wellest Integrative Health LLC | Clinic/Center | 142 Berkeley St Ste 402, Boston, MA 02116-5100 | 2020-02-27 |
| 1962986166 | Flourish Physical Therapy, LLC | Clinic/Center | 262 Beacon St Ste 5, Boston, MA 02116-1295 | 2018-09-24 |
| Find all providers in BOSTON | ||||
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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.