Active NPI
Sport & Spine Rehab of Columbia
- Chiropractor
- Columbia, MD
National Provider Identifier
1124230966
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- Legal business name
- SPORT & SPINE REHAB OF COLUMBIA
- Practice address
- 10760 Hickory Ridge Road
119
Columbia, MD 21044 - Phone
- (410) 964-0837
- NPI assigned
- May 4, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Jay S Greenstein, DC
- Title
- Ceo
- Phone
- (410) 964-0837
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | Primary | ||
| Physical Therapist | 225100000X |
Addresses
Primary practice location
10760 Hickory Ridge Road
119
Columbia, MD 21044
Mailing address
11418 Livingston Road
Ft. Washington, MD 20744
Phone (410) 964-0837
Other identifiers 10
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2103322 | Other | OPTIMUM CHOICE | |
| 4535854 | Other | AETNA PPO | |
| G921 | Other | BCBS OF NCA | |
| 3348462 | Other | AETNA HMO | |
| 200064 | Other | CIGNA PPO | |
| 200289 | Other | ASHN CIGNA HMO | |
| 2103322 | Other | MAMSI | |
| 2103322 | Other | ALLIANCE | |
| 2103322 | Other | MDIPA | |
| KEG7SP | Other | BCBS OF MD |
National Provider Directory
National Provider DirectoryLocations
10760 Hickory Ridge Rd
Ste 119
Columbia, MD 21044
Phone (410) 964-0837
Practitioners & affiliated clinicians
Practitioners 1
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.
-
- Chiropractor
- Columbia, MD
- NPI 1104897669
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178236800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1208649600000",
"number": "1124230966",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11418 LIVINGSTON ROAD",
"city": "FT. WASHINGTON",
"state": "MD",
"postal_code": "20744",
"telephone_number": "410-964-0837"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10760 HICKORY RIDGE ROAD",
"address_2": "119",
"city": "COLUMBIA",
"state": "MD",
"postal_code": "21044",
"telephone_number": "410-964-0837"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SPORT & SPINE REHAB OF COLUMBIA",
"organizational_subpart": "NO",
"enumeration_date": "2007-05-04",
"last_updated": "2008-04-20",
"status": "A",
"authorized_official_last_name": "GREENSTEIN",
"authorized_official_first_name": "JAY",
"authorized_official_middle_name": "S",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "410-964-0837",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "DC"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Chiropractor",
"state": null,
"license": null,
"primary": true
},
{
"code": "225100000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OPTIMUM CHOICE",
"identifier": "2103322",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA PPO",
"identifier": "4535854",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF NCA",
"identifier": "G921",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA HMO",
"identifier": "3348462",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA PPO",
"identifier": "200064",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ASHN CIGNA HMO",
"identifier": "200289",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAMSI",
"identifier": "2103322",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ALLIANCE",
"identifier": "2103322",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MDIPA",
"identifier": "2103322",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF MD",
"identifier": "KEG7SP",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Columbia, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.