Seaport Spine PLLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

SEAPORT SPINE PLLC

Practice address

212 Northern Ave
Boston, MA 02210-2089

Phone

(617) 519-3607

NPI assigned

Jan 28, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Ryan Hollien, DCNPI 1821333212

Title

Owner/Chiropractor

Phone

(617) 519-3607

Specialties & licenses 1

Addresses

Other names 1

• Seaport Spine & Sport Doing business as

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

Locations

Practitioners 1

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

• Ryan Patrick Hollien, DC

  • Chiropractor
  • Boston, MA
  • NPI 1821333212
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1580169600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580169600000",
    "number": "1255962379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 BUNTON ST",
            "city": "MILTON",
            "state": "MA",
            "postal_code": "021865704",
            "telephone_number": "617-519-3607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 NORTHERN AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022102089",
            "telephone_number": "617-519-3607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEAPORT SPINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-28",
        "last_updated": "2020-01-28",
        "certification_date": "2020-01-28",
        "status": "A",
        "authorized_official_last_name": "HOLLIEN",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "OWNER/CHIROPRACTOR",
        "authorized_official_telephone_number": "617-519-3607",
        "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": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Seaport Spine & Sport",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jasmine Zakiya Sealy-Norvin
• Ahmed Majid Sean
• Seaport Dental Associates LLC
• Seaport Diagnostics, Inc.
• Seaport Orthodontics, PC
• Lakeisha M Searcy
• Meghan M Searl, PHD
• Eileen F Searle, NP
• Frances Margaret Searle, NP
• David Eric C Searls, M.D.

• Chiropractor in Boston, MA
• Providers in Boston, MA by specialty
• Chiropractor in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2020; 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.