Organization Active NPI

Elevation Health and Performance PLLC

Doing business as Boulder Sports Chiropractic

  • Sports Physician Chiropractor
  • Boulder, CO
National Provider Identifier
1427411362
Registry record updated Jan 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
0007297 Issued in CO
Legal business name
ELEVATION HEALTH AND PERFORMANCE PLLC
Doing business as
Boulder Sports Chiropractic
Practice address
3000 Center Green Dr Ste 130
Boulder, CO 80301-2364
Phone
(303) 444-5105
NPI assigned
Mar 29, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2023

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

Authorized official

Name
Alyx Brown, DCNPI 1376925909
Title
Chiropractic Physician, Member
Phone
(503) 522-8818

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111NS0005X 0007297 CO Primary

Addresses

Primary practice location

3000 Center Green Dr Ste 130
Boulder, CO 80301-2364

Mailing address

3000 Center Green Dr Ste 130
Boulder, CO 80301-2364
Phone (303) 444-5105

Other identifiers 1

IdentifierTypeStateIssuer
443823YNHUOtherCOMEDICARE PTAN

Other names 1

  • Boulder Sports Chiropractic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170317000031 CO Part B Supplier - Clinic/Group Practice 5496030272 Receives reassigned benefits from 3 practitioners
Practice locations: Boulder, CO

National Provider Directory

National Provider Directory

Locations

3101 Iris Ave
Ste 220
Boulder, CO 80301
Phone (303) 444-5105

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1459209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673395200000",
    "number": "1427411362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 CENTER GREEN DR STE 130",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803012364",
            "telephone_number": "303-444-5105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 CENTER GREEN DR STE 130",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803012364",
            "telephone_number": "303-444-5105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELEVATION HEALTH AND PERFORMANCE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-29",
        "last_updated": "2023-01-11",
        "certification_date": "2023-01-11",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "ALYX",
        "authorized_official_title_or_position": "CHIROPRACTIC PHYSICIAN, MEMBER",
        "authorized_official_telephone_number": "503-522-8818",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Sports Physician",
            "state": "CO",
            "license": "0007297",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "443823YNHU",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Boulder Sports Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Boulder Sports Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Boulder, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.