Advanced Sports and Family Chiropractic, LLC
Organization Active NPI Chiropractor · Overland Park, KS
NPI 1376710293 · NPPES record last updated May 22, 2014
Key facts
- NPI
- 1376710293
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- License
- 0105014 (KS)
- Legal business name
- ADVANCED SPORTS AND FAMILY CHIROPRACTIC, LLC
- Practice address
- 12643 Metcalf Ave
Overland Park, KS 66213-1317 - Phone
- (913) 643-1771
- Fax
- (913) 643-1775
- NPI assigned
- May 9, 2008
- Organization subpart
- No
Authorized official
- Name
- Dr. Brad Michael Woodle, DC
- Title
- President
- Phone
- (913) 643-1771
Practitioners 30
-
Jacob John Fanders, D.C.
-
Aleesa Harris, DC
-
Alek Santo, DC
-
Brandon D Wiese, DC
-
Drew Woodle, DC
-
Myron Collins, DC
-
Nathan T Hoover, DC
-
Joseph Li, D.C.
-
Ryan Maurice Nogle, D.C.
-
Sam Weaver, DC
-
David Demetrius Wilson, DC, MS
-
Kolt Newell, DC
-
Daniel Joseph Sallee, D.C.
-
Anthony Sala, D.C.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in KS, MO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080522000538 | KS | Part B Supplier - Clinic/Group Practice | 7517036023 |
Receives reassigned benefits from 10 practitioners Practice locations: Olathe, KS; Overland Park, KS; Prairie Village, KS |
| O20140617000294 | MO | Part B Supplier - Clinic/Group Practice | 7517036023 |
Receives reassigned benefits from 17 practitioners Practice locations: Lees Summit, MO; Overland Park, KS; Belton, MO |
National Provider Directory
Locations
10454 S Ridgeview Rd
Olathe, KS 66061
Phone (913) 643-1771
6701 W 121st St
Ste 200
Overland Park, KS 66209
Phone (913) 379-9550
12643 Metcalf Ave
Overland Park, KS 66213
Phone (913) 643-1771
4121 W 83rd St
Ste 147
Prairie Village, KS 66208
Phone (913) 490-4444
17027 Bel Ray Blvd
Belton, MO 64012
Phone (816) 425-7015
338 SW Main St
Lees Summit, MO 64063
Phone (816) 600-5483
1520 N Church Rd
Ste C
Liberty, MO 64068
Phone (816) 831-3600
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | 0105014 | KS | Yes |
Addresses
Primary practice location
12643 Metcalf Ave
Overland Park, KS 66213-1317
Mailing address
12643 Metcalf Ave
Overland Park, KS 66213-1317
Phone (913) 643-1771
Other providers in Overland Park, KS
- Advanced Orthopedics and Sports Medicine
- Advanced Physical Therapy and Sports Rehabilitation, PA
- Advanced Radiation Center of Kansas City LLC
- Advanced Radiology Consultants of Kansas City, PA
- Advanced Spine & Orthopaedic Specialists, PA
- Advantage Counseling Services
- Advantage Health Group, Inc.
- Adventhealth South Overland Park, Inc.
- Adw Diabetes LLC
- Adw Diabetes LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 22, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.