Active NPI
Jay P Sportsman, DC
- Chiropractor
- Kansas City, MO
National Provider Identifier
1306853098
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 2002032135
- Practice address
- 3715 N Oak Trafficway
Kansas City, MO 64116 - Phone
- (816) 455-1414
- Fax
- (816) 455-8343
- NPI assigned
- Aug 2, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 2002032135 | MO | Primary |
Addresses
Primary practice location
3715 N Oak Trafficway
Kansas City, MO 64116
Mailing address
6453 N Amoret Ave
Kansas City, MO 64151
Phone (816) 507-4613
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 33601017 | Other | MO | BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050215000807 | MO | Practitioner - Chiropractic | 7810949138 | Practice locations: Gladstone, MO |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Cleveland Chiropractic College - Kansas City, 2002
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
2909 NE Brooktree Lane
Gladstone, MO 64119-1874
2909 NE Brooktree Lane
Sportsman Chiropractic
Gladstone, MO 64119
Phone (816) 455-1414
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2002032135 | MO | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154476800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1306853098",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6453 N AMORET AVE",
"city": "KANSAS CITY",
"state": "MO",
"postal_code": "64151",
"telephone_number": "816-507-4613",
"fax_number": "816-455-8343"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3715 N OAK TRAFFICWAY",
"city": "KANSAS CITY",
"state": "MO",
"postal_code": "64116",
"telephone_number": "816-455-1414",
"fax_number": "816-455-8343"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPORTSMAN",
"first_name": "JAY",
"middle_name": "P",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MO",
"license": "2002032135",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "33601017",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kansas City, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.