NPIMap

Organization Active NPI

Sports and Functional Medicine

  • Chiropractor
  • Scottsdale, AZ
National Provider Identifier
1174829584
Registry record updated Mar 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
6058 Issued in AZ
Legal business name
SPORTS AND FUNCTIONAL MEDICINE
Practice address
9316 E Raintree Dr
Suite 140
Scottsdale, AZ 85260-3005
Phone
(480) 614-2322
Fax
(480) 614-2522
NPI assigned
Feb 2, 2011
Last updated
Mar 2, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2011

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

Authorized official

Name
Dr. Simon Mark Billingham, D.C.NPI 1699863696
Title
President
Phone
(480) 614-2322

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 6058 AZ Primary

Addresses

Primary practice location

9316 E Raintree Dr
Suite 140
Scottsdale, AZ 85260-3005

Mailing address

9316 E Raintree Dr
Suite 140
Scottsdale, AZ 85260-3005
Phone (480) 614-2322

National Provider Directory

National Provider Directory

Locations

9316 E Raintree Dr
Ste 140
Scottsdale, AZ 85260
Phone (480) 614-2322

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1296604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299024000000",
    "number": "1174829584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9316 E RAINTREE DR",
            "address_2": "SUITE 140",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852603005",
            "telephone_number": "480-614-2322",
            "fax_number": "480-614-2522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9316 E RAINTREE DR",
            "address_2": "SUITE 140",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852603005",
            "telephone_number": "480-614-2322",
            "fax_number": "480-614-2522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPORTS AND FUNCTIONAL MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-02",
        "last_updated": "2011-03-02",
        "status": "A",
        "authorized_official_last_name": "BILLINGHAM",
        "authorized_official_first_name": "SIMON",
        "authorized_official_middle_name": "MARK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "480-614-2322",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "6058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.