NPIMap

Organization Active NPI

Sports and Spine Healthcare LLC

  • Neurology Chiropractor
  • Vineland, NJ
National Provider Identifier
1013593748
Registry record updated Mar 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology ChiropractorTaxonomy code 111NN0400X
Legal business name
SPORTS AND SPINE HEALTHCARE LLC
Practice address
1027 E Chestnut Ave
Vineland, NJ 08360-5838
Phone
(856) 691-6055
NPI assigned
Mar 23, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2021

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

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111NN0400X Primary

Addresses

Primary practice location

1027 E Chestnut Ave
Vineland, NJ 08360-5838

Mailing address

1027 E Chestnut Ave
Vineland, NJ 08360-5838
Phone (856) 691-6055

Other names 2

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

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL https://www.zhealthehr.com/?error Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210413000528 NJ Part B Supplier - Clinic/Group Practice 5698183630 Receives reassigned benefits from 6 practitioners
Practice locations: Vineland, NJ

National Provider Directory

National Provider Directory

Locations

501 Bay Ave
Ste 106
Somers Point, NJ 08244
Phone (609) 365-8881

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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"
        }
    ]
}

Other providers in Vineland, NJ

Sources for this page

  • 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.