SPINE & SPORTS INJURY CENTER, P.C. (NPI# 1891840922) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891840922 |
| Entity Type | Organization |
| Organization Name | SPINE & SPORTS INJURY CENTER, P.C. |
| Practice Address |
4 Avery St Boston MA 02111-1005 |
| Mailing Address |
2 Avery St 27f Boston MA 02111-1002 |
| Practice Telephone | 6173758580 |
| Practice Fax Number | 6173758581 |
| Mailing Telephone | 6173758580 |
| Mailing Fax Number | 6173758581 |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2007-11-29 |
| Authorized Official Name | DR. RICHARD LAWRENCE GREEN (PRESIDENT) |
| Authorized Official Telephone | 6173758580 |
| Authorized Official Credential | DC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 966 | MA | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | MEDICARE GROUP # | Y49258 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649479395 | Spine & Sports Injury Center, P.C. | Clinic/Center | 4 Avery St, 4th Floor, Boston, MA 02111-1005 | 2007-07-13 |
| Street Address |
4 AVERY ST |
| 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 |
| 1649479395 | Spine & Sports Injury Center, P.C. | Clinic/Center | 4 Avery St, 4th Floor, Boston, MA 02111-1005 | 2007-07-13 |
| 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 | 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 |
|---|---|---|---|---|
| 1649779281 | Timothy Simansky D.c. P.C. | Chiropractor | 139 Beacon St Apt 2, Boston, MA 02116-1559 | 2018-02-09 |
| 1881102432 | Kristen Bova | Chiropractor | 79a Prince St, Boston, MA 02113-1701 | 2018-01-17 |
| 1700264397 | Eunheay Lee | Chiropractor | 30 Fenway, Unit 1, Boston, MA 02215-4004 | 2015-05-14 |
| 1144623687 | Elevate Health Cambridge | Chiropractor | 72 Bakersfield St Unit 3, Boston, MA 02125-1901 | 2014-09-29 |
| 1073959409 | A Touch of Health Chiropractic Boston, LLC | Chiropractor | 61 Endicott St, Boston, MA 02113-2202 | 2013-05-13 |
| 1821333212 | Ryan Patrick Hollien | Chiropractor | 212 Northern Ave, Boston, MA 02210-2089 | 2012-12-11 |
| 1912265778 | Malori Tinsley | Chiropractor | 183 Beacon St, Apartment 1r, Boston, MA 02116 | 2012-04-30 |
| 1861761587 | Inyoung Yang | Chiropractor | 30 Fenway Ste 1, Boston, MA 02215-4016 | 2011-12-27 |
| 1912213216 | Clayton John Blanchette | Chiropractor | 441 Stuart St Fl 3, Boston, MA 02116-5019 | 2010-08-24 |
| 1689994907 | Chung-tser Blair Lee | Chiropractor | 50 Congress St, Suite 7, Boston, MA 02109-4002 | 2010-06-09 |
| 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.