Active NPI
Kim Harrison Sperry, D.C.
- Chiropractor
- Lake Jackson, TX
National Provider Identifier
1407990625
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- DC2864
- Practice address
- 104 Circle Way St
Suite D
Lake Jackson, TX 77566-5200 - Phone
- (979) 297-0002
- Fax
- (979) 297-0002
- NPI assigned
- Feb 19, 2007
- Last updated
- Dec 19, 2011
- Sex
- Male
- Sole proprietor
- Yes
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 | DC2864 | TX | Primary |
Addresses
Primary practice location
104 Circle Way St
Suite D
Lake Jackson, TX 77566-5200
Mailing address
104 Circle Way St
Suite D
Lake Jackson, TX 77566-5200
Phone (979) 297-0002
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 760047771 | Other | TX | TAX IDENTIFICATION NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DC2864 | TX | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171843200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1324252800000",
"number": "1407990625",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "104 CIRCLE WAY ST",
"address_2": "SUITE D",
"city": "LAKE JACKSON",
"state": "TX",
"postal_code": "775665200",
"telephone_number": "979-297-0002",
"fax_number": "979-297-0002"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "104 CIRCLE WAY ST",
"address_2": "SUITE D",
"city": "LAKE JACKSON",
"state": "TX",
"postal_code": "775665200",
"telephone_number": "979-297-0002",
"fax_number": "979-297-0002"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPERRY",
"first_name": "KIM",
"middle_name": "HARRISON",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-19",
"last_updated": "2011-12-19",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "TX",
"license": "DC2864",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX IDENTIFICATION NUMBER",
"identifier": "760047771",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lake Jackson, TX
- South Texas Radiation Oncology PLLC
- Southwest Sids Research Institute, Inc.
- Southwest Sids Research Institute, Inc.
- Frank Jesse Spates, OT
- Spence's Medical Center Pharmacy
- Marlyn Spradley-Bogan, COTA
- Springs Pediatrics Associates PLLC
- Ginger Battle Stagg, DDS
- Starr Plus Pharmacy, LLC.
- Stephanie Herrera, M.D and Associates, PA (Lake Jackson Ear, Nose and Throat)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 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.