Spine and Sports Injury Center, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

SPINE AND SPORTS INJURY CENTER, LLC

Doing business as

Complete Family Care

Practice address

1001 E Bogard Rd
Wasilla, AK 99654-7114

Phone

(907) 376-2225

Fax

(907) 376-9225

NPI assigned

Aug 12, 2011

Last updated

Feb 4, 2025By 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. Kristofer D Larson, D.C.NPI 1417029976

Title

Managing Member

Phone

(907) 376-2225

Specialties & licenses 3

Addresses

Other names 1

• Complete Family Care Doing business as

Medicare fee-for-service enrollment

Enrolled in AK

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

• Back in Action Physical Therapy, LLC

  • Physical Therapist
  • Wasilla, AK
  • NPI 1356621395

  Member Of

  NPD member
• Larson Chiropractic, LLC

  • Sports Physician Chiropractor
  • Wasilla, AK
  • NPI 1801176672

  Member Of

  NPD member

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Back in Action Physical Therapy, LLC

  • Physical Therapist
  • Wasilla, AK
  • NPI 1356621395
  NPPES parent name
• Larson Chiropractic, LLC

  • Sports Physician Chiropractor
  • Wasilla, AK
  • NPI 1801176672
  NPPES parent name

Practitioners 5

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.

• Patricia Gail Johnson, DO

  • Family Medicine Physician
  • Wasilla, AK
  • NPI 1750441820
  Medicare reassignment Care Compare group NPD
• Amanda Constance Weidman, APRN, FNP-C

  • Nurse Practitioner
  • Wasilla, AK
  • NPI 1356105951
  Medicare reassignment Care Compare group NPD
• Margaret Maixner, ANP

  • Family Nurse Practitioner
  • Big Lake, AK
  • NPI 1467824359
  Medicare reassignment Care Compare group
• John Wayne Moore, PA-C

  • Medical Physician Assistant
  • Wasilla, AK
  • NPI 1669552550
  Medicare reassignment Care Compare group
• Kristofer Daniel Larson, DC

  • Sports Physician Chiropractor
  • Wasilla, AK
  • NPI 1417029976
  Authorized official Same address or phone

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

{
    "created_epoch": "1313107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738627200000",
    "number": "1053690677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 E BOGARD RD",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547114",
            "telephone_number": "907-376-2225",
            "fax_number": "907-376-9225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 E BOGARD RD",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547114",
            "telephone_number": "907-376-2225",
            "fax_number": "907-376-9225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPINE AND SPORTS INJURY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-12",
        "last_updated": "2025-02-04",
        "certification_date": "2025-02-04",
        "status": "A",
        "authorized_official_last_name": "LARSON",
        "authorized_official_first_name": "KRISTOFER",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "907-376-2225",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Sports Physician",
            "state": "AK",
            "license": "435",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Complete Family Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Stephen Spees, OT
• Claudia Spencer
• Katie Spencer, LMT
• Darlene Sperry
• Jolene Marie Spiller
• Genai Spiroski
• Jeffrey L Sponsler, M.D.
• Sports Injury Chiropractic
• Danielle Sprague
• Marianne Spur, OT

• Family Medicine Physician in Wasilla, AK
• Providers in Wasilla, AK by specialty
• Family Medicine Physician in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.