Advanced Sports Injury & Spinal Care LLC

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

License

1430 Issued in LA

Legal business name

ADVANCED SPORTS INJURY & SPINAL CARE LLC

Practice address

1322 Elton Rd Ste K
Jennings, LA 70546-4100

Phone

(337) 824-2901

NPI assigned

Aug 21, 2008

Last updated

Sep 25, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Lisa G Goddard

Title

Office MGR

Phone

(337) 824-2901

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in LA

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, and the practitioner matching its NPPES authorized official.

• Joel Harris Conner, D.C.

  • Chiropractor
  • Jennings, LA
  • NPI 1548394489
  Medicare reassignment NPD

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

{
    "created_epoch": "1219276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222300800000",
    "number": "1275780181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1322 ELTON RD STE K",
            "city": "JENNINGS",
            "state": "LA",
            "postal_code": "705464100",
            "telephone_number": "337-824-2901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1322 ELTON RD STE K",
            "city": "JENNINGS",
            "state": "LA",
            "postal_code": "705464100",
            "telephone_number": "337-824-2901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED SPORTS INJURY & SPINAL CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-21",
        "last_updated": "2008-09-25",
        "status": "A",
        "authorized_official_last_name": "GODDARD",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OFFICE MGR",
        "authorized_official_telephone_number": "337-824-2901",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "LA",
            "license": "1430",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1072770",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Derrious Adams
• Melvin Adams, MHS
• Veronica Ebihomo Adoun, MD
• Advanced Family Eyecare, LLC (Advanced Family Eyecare)
• Advanced Medical Imaging
• Daryl J Albro, MPT
• Alchemyrx LLC
• Aldes Rozas MD Inc
• Sheryl Alexander
• Alexandria Vamc

• Preferred Provider Organization in Jennings, LA
• Providers in Jennings, LA by specialty
• Preferred Provider Organization in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2008; 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.