Express Sport and Spine S.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

EXPRESS SPORT AND SPINE S.C.

Doing business as

Sport and Spine Recovery Clinic

Practice address

414 W Main St
Sun Prairie, WI 53590-2912

Phone

(608) 514-1842

Fax

(608) 305-8726

NPI assigned

Aug 1, 2021

Organization subpart

No

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

Authorized official

Name

Nathaniel A Drees, DCNPI 1003368630

Title

Owner/Employee

Phone

(312) 934-8542

Specialties & licenses 1

Addresses

Other names 1

• Sport and Spine Recovery Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Nathaniel Alan Drees, DC, CSCS

  • Chiropractor
  • Sun Prairie, WI
  • NPI 1003368630
  Medicare reassignment NPD Authorized official
• Austin Erickson, DC

  • Chiropractor
  • Sun Prairie, WI
  • NPI 1104791367
  Medicare reassignment NPD

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

{
    "created_epoch": "1627776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719878400000",
    "number": "1215600507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 W MAIN ST",
            "city": "SUN PRAIRIE",
            "state": "WI",
            "postal_code": "535902912",
            "telephone_number": "608-514-1842",
            "fax_number": "608-305-8726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 W MAIN ST",
            "city": "SUN PRAIRIE",
            "state": "WI",
            "postal_code": "535902912",
            "telephone_number": "608-514-1842",
            "fax_number": "608-305-8726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXPRESS SPORT AND SPINE S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-01",
        "last_updated": "2024-07-02",
        "certification_date": "2024-07-02",
        "status": "A",
        "authorized_official_last_name": "DREES",
        "authorized_official_first_name": "NATHANIEL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER/EMPLOYEE",
        "authorized_official_telephone_number": "312-934-8542",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sport and Spine Recovery Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sport and Spine Recovery Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Austin Erickson, DC
• Christeena Wave Rita Evans, LPN
• Chloe Marie Everett, SAC-IT
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• Machaela Marie Exner
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• Eye Wisconsin LLC
• F&E Adult Home Care, LLC
• Karina Falcon Gonzalez
• Brody Thomas Fanshaw, MS, LPC

• Chiropractor in Sun Prairie, WI
• Providers in Sun Prairie, WI by specialty
• Chiropractor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2024; 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.