NPIMap

Organization Active NPI

Redlands Spine and Sport

  • Sports Physician Chiropractor
  • Redlands, CA
National Provider Identifier
1376812362
Registry record updated Dec 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
DC-28061 Issued in CA
Legal business name
REDLANDS SPINE AND SPORT
Practice address
219 E Olive Ave
Redlands, CA 92373-5251
Phone
(909) 793-2225
NPI assigned
Dec 20, 2011
Last updated
Dec 20, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2011

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

Authorized official

Name
Dr. Michael S Donia, DCNPI 1356496996
Title
Doctor/President
Phone
(909) 793-2225

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111NS0005X DC-28061 CA Primary

Addresses

Primary practice location

219 E Olive Ave
Redlands, CA 92373-5251

Mailing address

219 E Olive Ave
Redlands, CA 92373-5251
Phone (909) 793-2225

Other identifiers 1

IdentifierTypeStateIssuer
BP542AOtherCAMEDICARE PTAN

National Provider Directory

National Provider Directory

Locations

219 E Olive Ave
Redlands, CA 92373
Phone (909) 793-2225

1455 W Park Ave
Redlands, CA 92373
Phone (909) 793-1334

Practitioners & affiliated clinicians

Practitioners 12

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": "1324339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1324339200000",
    "number": "1376812362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 E OLIVE AVE",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923735251",
            "telephone_number": "909-793-2225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 E OLIVE AVE",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923735251",
            "telephone_number": "909-793-2225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REDLANDS SPINE AND SPORT",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-20",
        "last_updated": "2011-12-20",
        "status": "A",
        "authorized_official_last_name": "DONIA",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "DOCTOR/PRESIDENT",
        "authorized_official_telephone_number": "909-793-2225",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Sports Physician",
            "state": "CA",
            "license": "DC-28061",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "BP542A",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Redlands, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2011; 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.