Sports and Spine Healthcare LLC

Primary specialty

Neurology ChiropractorTaxonomy code 111NN0400X

Legal business name

SPORTS AND SPINE HEALTHCARE LLC

Doing business as

Evergreen Healthcare Associates
Sports & Spine Healthcare LLC

Practice address

1027 E Chestnut Ave
Vineland, NJ 08360-5838

Phone

(856) 691-6055

NPI assigned

Mar 23, 2021

Last updated

Mar 31, 2021By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Kirishma Patel, DCNPI 1801285945

Title

Ceo

Phone

(848) 219-2657

Specialties & licenses 1

Addresses

Other names 2

• Evergreen Healthcare Associates Doing business as
• Sports & Spine Healthcare LLC Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kirishma J Patel, DC

  • Chiropractor
  • Northfield, NJ
  • NPI 1801285945
  Medicare reassignment Care Compare group NPD Authorized official
• Nicholas Blood

  • Occupational Therapist
  • Cherry Hill, NJ
  • NPI 1730826934
  Medicare reassignment Care Compare group NPD
• Taylor Boulos, APN

  • Nurse Practitioner
  • Little Silver, NJ
  • NPI 1356820823
  Medicare reassignment Care Compare group NPD
• Lester Zavala, DC

  • Chiropractor
  • Somers Point, NJ
  • NPI 1003771759
  Medicare reassignment Care Compare group NPD
• Latia M Pierce, APN

  • Psychiatric/Mental Health Nurse Practitioner
  • Vineland, NJ
  • NPI 1740640309
  Medicare reassignment NPD
• Andrea Diane Phillips, D.C.

  • Chiropractor
  • Louisville, CO
  • NPI 1316026909

  NJ

  Medicare reassignment

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1616457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617148800000",
    "number": "1013593748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1027 E CHESTNUT AVE",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083605838",
            "telephone_number": "856-691-6055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1027 E CHESTNUT AVE",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083605838",
            "telephone_number": "856-691-6055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPORTS AND SPINE HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-23",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-31",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "KIRISHMA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "848-219-2657",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111NN0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://www.zhealthehr.com/?error",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1027 E Chestnut Ave",
            "city": "Vineland",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "083605838",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Evergreen Healthcare Associates",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sports & Spine Healthcare LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Scott Evan Spagnolo-Hye, D.O.
• Rachel Dawn Spayd, DO
• Yaa Spike
• Michael Spivak, D.O.
• Ann Marie Spoltore, CNM
• Sprague Dialysis LLC (Vineland Dialysis)
• Alicia M Sprague, DOULA
• Austin Walter Spray
• Spring Services
• Scott Adam Springer, DO

• Neurology Chiropractor in Vineland, NJ
• Providers in Vineland, NJ by specialty
• Neurology Chiropractor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.