Omaha Spine and Sport, Functional Chiropractic Center, PC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

1328 Issued in NE

Legal business name

OMAHA SPINE AND SPORT, FUNCTIONAL CHIROPRACTIC CENTER, PC

Practice address

15615 Pacific St Ste 106
Omaha, NE 68118-2118

Phone

(402) 933-4447

Fax

(402) 933-4857

NPI assigned

May 10, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Corey J Campbell, DC

Title

Chiropractor/President

Phone

(402) 933-4447

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1336608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337731200000",
    "number": "1407115488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15615 PACIFIC ST STE 106",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681182118",
            "telephone_number": "402-933-4447",
            "fax_number": "402-933-4857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15615 PACIFIC ST STE 106",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681182118",
            "telephone_number": "402-933-4447",
            "fax_number": "402-933-4857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OMAHA SPINE AND SPORT, FUNCTIONAL CHIROPRACTIC CENTER, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-10",
        "last_updated": "2012-05-23",
        "status": "A",
        "authorized_official_last_name": "CAMPBELL",
        "authorized_official_first_name": "COREY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CHIROPRACTOR/PRESIDENT",
        "authorized_official_telephone_number": "402-933-4447",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NE",
            "license": "1328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Omaha, NE
• Providers in Omaha, NE by specialty
• Chiropractor in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2012; 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.