Sport and Spine Chiropractic PLLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

SPORT AND SPINE CHIROPRACTIC PLLC

Practice address

2155 E University Dr Ste 111
Tempe, AZ 85281-4685

Phone

(480) 454-4776

NPI assigned

Mar 19, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Robert Dylan Hernandez, DC

Title

Owner

Phone

(702) 277-0578

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Axis Spine and Sport Doing business as

Locations

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

{
    "created_epoch": "1584576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1584576000000",
    "number": "1194351379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2155 E UNIVERSITY DR STE 111",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852814685",
            "telephone_number": "480-454-4776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2155 E UNIVERSITY DR STE 111",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852814685",
            "telephone_number": "480-454-4776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPORT AND SPINE CHIROPRACTIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-19",
        "last_updated": "2020-03-19",
        "certification_date": "2020-03-19",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "DYLAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-277-0578",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1548802333",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Axis Spine and Sport",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Spinal Disc Solutions
• Spine & Sports Rehabilitation Institute
• Spine & Wellness Anesthesia Group, LLC
• Christine Spiwak
• Erik David Spletter, PA
• Linda Faye Squalls
• Squaw Peak Anesthesia Inc
• Paul Singh Sraow, M.D.
• Anitha Sreeni, NP-C
• Jayashree Srinivasan, DMD

• Chiropractor in Tempe, AZ
• Providers in Tempe, AZ by specialty
• Chiropractor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2020; 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.