NPIMap

Organization Active NPI

Denver Sport and Spine Inc

  • Sports Physician Chiropractor
  • Denver, CO
National Provider Identifier
1124371570
Registry record updated Sep 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
6656 Issued in CO
Legal business name
DENVER SPORT AND SPINE INC
Practice address
3441 Tennyson St
Denver, CO 80212-1723
Phone
(303) 955-5994
Fax
(303) 993-2681
NPI assigned
Oct 23, 2012
Last updated
Sep 6, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2023

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

Authorized official

Name
Jonathan Rober Rager WeimerNPI 1023302205
Title
Owner/President
Phone
(303) 960-8016

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
Sports Physician ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111NS0005X 6656 CO Primary

Addresses

Primary practice location

3441 Tennyson St
Denver, CO 80212-1723

Mailing address

3441 Tennyson St
Denver, CO 80212-1723
Phone (303) 955-5994

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130226000376 CO Part B Supplier - Clinic/Group Practice 4981859881 Receives reassigned benefits from 2 practitioners
Practice locations: Denver, CO

National Provider Directory

National Provider Directory

Locations

3441 Tennyson St
Denver, CO 80212
Phone (303) 941-0664

3801 Osage St
Denver, CO 80211
Phone (303) 955-5994

Practitioners & affiliated clinicians

Practitioners 17

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.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1350950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693958400000",
    "number": "1124371570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3441 TENNYSON ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802121723",
            "telephone_number": "303-955-5994",
            "fax_number": "303-993-2681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3441 TENNYSON ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802121723",
            "telephone_number": "303-955-5994",
            "fax_number": "303-993-2681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENVER SPORT AND SPINE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-23",
        "last_updated": "2023-09-06",
        "certification_date": "2021-06-08",
        "status": "A",
        "authorized_official_last_name": "WEIMER",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "ROBER RAGER",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "303-960-8016"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Sports Physician",
            "state": "CO",
            "license": "6656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2023; 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.