NPIMap

Organization Active NPI

605 Sport and Spine

  • Clinic/Center
  • Stevens Point, WI
National Provider Identifier
1235776691
Registry record updated Sep 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
605 SPORT AND SPINE
Practice address
2212 Division St
Stevens Point, WI 54481-3661
Phone
(715) 544-6364
NPI assigned
Dec 4, 2019
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
Dr. Tanner G Ozanne, DC, ATCNPI 1427509439
Title
Owner
Phone
(715) 544-6364

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
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

2212 Division St
Stevens Point, WI 54481-3661

Mailing address

2212 Division St
Stevens Point, WI 54481-3661
Phone (715) 544-6364

National Provider Directory

National Provider Directory

Locations

2212 Division St
Stevens Point, WI 54481
Phone (715) 341-0198

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.

NPI Registry JSON

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

{
    "created_epoch": "1575417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693958400000",
    "number": "1235776691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2212 DIVISION ST",
            "city": "STEVENS POINT",
            "state": "WI",
            "postal_code": "544813661",
            "telephone_number": "715-544-6364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2212 DIVISION ST",
            "city": "STEVENS POINT",
            "state": "WI",
            "postal_code": "544813661",
            "telephone_number": "715-544-6364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "605 SPORT AND SPINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-04",
        "last_updated": "2023-09-06",
        "certification_date": "2021-03-12",
        "status": "A",
        "authorized_official_last_name": "OZANNE",
        "authorized_official_first_name": "TANNER",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "715-544-6364",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC, ATC"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stevens Point, WI

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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.