SPINE AND SPORT CENTER (NPI# 1801263256) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801263256 |
| Entity Type | Organization |
| Organization Name | SPINE AND SPORT CENTER |
| Practice Address |
205 N Grand Ave W Springfield IL 62702-2550 |
| Practice Telephone | 2175252035 |
| Mailing Telephone | 2175252035 |
| Enumeration Date | 2015-09-01 |
| Last Update Date | 2015-09-24 |
| Authorized Official Name | DR. CASEY S SITKO (GENERAL MANAGER) |
| Authorized Official Telephone | 2175252035 |
| Authorized Official Credential | D.C. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 038012871 | IL | Chiropractic Providers |
| Street Address |
205 N GRAND AVE W |
| City | SPRINGFIELD |
| State | IL |
| Zip Code | 62702-2550 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730234436 | Rodney Alan Holzmacher | Chiropractor | 205 N Grand Ave W, Springfield, IL 62702-2550 | 2007-01-24 |
| 1538667746 | Cody Derek Needham | Chiropractor | 205 N Grand Ave W, Springfield, IL 62702-2550 | 2018-01-23 |
| 1841708351 | Sitko Chiropractic 2, LLC | Chiropractor | 205 N Grand Ave W, Springfield, IL 62702-2550 | 2018-01-18 |
| 1629585393 | Kyle James Sitko | Chiropractor | 205 N Grand Ave W, Springfield, IL 62702-2550 | 2018-01-03 |
| 1114394640 | Casey S Sitko | Chiropractor | 205 N Grand Ave W, Springfield, IL 62702-2550 | 2015-09-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457866519 | Mohammad Jamal Uddin Ansari | Internal Medicine | 751 N Rutledge St Ste 400, Springfield, IL 62702 | 2017-12-11 |
| 1588105811 | Mickey Graphia | Surgery | 701 N 1st St # D346, Springfield, IL 62702 | 2017-03-20 |
| 1376908913 | Abdul Hannan | Internal Medicine | 315 W Carpenter St # B, Springfield, IL 62702 | 2015-12-28 |
| 1871986414 | Rachel Hoselton | Nurse Practitioner | 400 N 9th St Fl 4, Springfield, IL 62702 | 2015-03-06 |
| 1548697774 | Alyssa Wilson | Behavioral Analyst | 232 Bruns Lane, One Sparcenter Plaza, Springfield, IL 62702 | 2013-10-02 |
| 1174965446 | Amy Wilson | Speech-Language Pathologist | 2120 West Washington Street, Springfield, IL 62702 | 2013-07-26 |
| 1275898116 | Pele Boutrous Dina | Pediatrics | 415 N 9th St # 4w16, Springfield, IL 62702 | 2012-07-06 |
| 1427327733 | Brook D Croke | Genetic Counselor, MS | 400 N. 9th Street, 3rd Floor Clinic B, Springfield, IL 62702 | 2011-12-16 |
| 1629352604 | Renae M Sanchez | Pharmacist | 3216 East Clearlake Ave, Springfield, IL 62702 | 2011-10-07 |
| 1982915302 | William Leland Zelkovich | Radiology | 701 N 1st, Springfield, IL 62702 | 2010-06-30 |
| Find all providers in zip 62702 | ||||
| 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 |
|---|---|---|---|---|
| 1376140616 | Springfield Chiropractic LLC | Chiropractor | 505 N Laurel St, Springfield, GA 31329-6815 | 2020-10-08 |
| 1578179412 | James Crawford | Chiropractor | 2144 E Republic Rd Ste A104, Springfield, MO 65804-4645 | 2020-09-16 |
| 1982218103 | Western Mass Chiropractic PC | Chiropractor | 275 Bicentennial Hwy Ste 211, Springfield, MA 01118-1965 | 2020-09-04 |
| 1730725425 | Chiro One Wellness Center of Springfield, LLC | Chiropractor | 3409 Freedom Dr Ste 150a, Springfield, IL 62704-6517 | 2019-11-18 |
| 1508408493 | Amrit Justin Jhauj | Chiropractor | 355 Us-22 East, Springfield, NJ 07081 | 2019-10-11 |
| 1992355473 | Candace Bahk Kim | Chiropractor | 6225 Brandon Ave Ste 175, Springfield, VA 22150-2519 | 2019-09-16 |
| 1558826545 | Adrian Bryon Hunter | Chiropractor | 6130 Brandon Ave, Springfield, VA 22150-2610 | 2019-02-05 |
| 1720554959 | Revive Health and Injury Center, LLC | Chiropractor | 333 N Limestone St Ste 104, Springfield, OH 45503-4250 | 2018-10-15 |
| 1831693621 | Michael Benjamin Chiapetto | Chiropractor | 1340 S State St, Springfield, IL 62704-3625 | 2018-03-19 |
| 1134637382 | Gnr Chiropractic LLC | Chiropractor | 2700 W Lawrence Ave Ste J3, Springfield, IL 62704-7201 | 2018-01-22 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 62702 |
Please comment or provide details below to improve the information on SPINE AND SPORT CENTER.
| 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.