NPIMap

Organization Active NPI

Align Spine and Sports Rehab, PLLC

  • Rehabilitation Chiropractor
  • Desoto, TX
National Provider Identifier
1295302347
Registry record updated Jun 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
Legal business name
ALIGN SPINE AND SPORTS REHAB, PLLC
Practice address
700 Mirkes Pkwy
Desoto, TX 75115-2972
Phone
(469) 346-8573
NPI assigned
Jun 8, 2021
Last updated
Jun 8, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2021

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

Authorized official

Name
Dr. Porcha Anderson, DCNPI 1417463498
Title
Clinical Director
Phone
(469) 346-8573

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X
Rehabilitation Chiropractor 111NR0400X Primary

Addresses

Primary practice location

700 Mirkes Pkwy
Desoto, TX 75115-2972

Mailing address

700 Mirkes Pkwy
Desoto, TX 75115-2972
Phone (469) 346-8573

Other identifiers 2

IdentifierTypeStateIssuer
1417463498MedicaidTX
1215448063MedicaidTX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1623110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623110400000",
    "number": "1295302347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 MIRKES PKWY",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751152972",
            "telephone_number": "469-346-8573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 MIRKES PKWY",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751152972",
            "telephone_number": "469-346-8573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALIGN SPINE AND SPORTS REHAB, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-08",
        "last_updated": "2021-06-08",
        "certification_date": "2021-06-08",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "PORCHA",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "469-346-8573",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1417463498",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1215448063",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Desoto, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2021; 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.