Sport & Spine of Rehab McLean PLLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

SPORT & SPINE OF REHAB MCLEAN PLLC

Practice address

6845 Elm St
Ste 425
MC Lean, VA 22101-6007

Phone

(703) 448-5799

Fax

(240) 766-0304

NPI assigned

May 4, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Jay S Greenstein, DC

Title

Ceo

Phone

(240) 766-0300

Specialties & licenses 2

Addresses

Other identifiers 10

Locations

Practitioners 1

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

• Sheldon Joseph Stuckart, DC

  • Chiropractor
  • Rockville, MD
  • NPI 1720603277
  NPD (past)

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1304640000000",
    "number": "1497967251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9300 LIVINGSTON RD",
            "address_2": "STE 100",
            "city": "FT WASHINGTON",
            "state": "MD",
            "postal_code": "207444914",
            "telephone_number": "240-766-0300",
            "fax_number": "240-766-0304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6845 ELM ST",
            "address_2": "STE 425",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221016007",
            "telephone_number": "703-448-5799",
            "fax_number": "240-766-0304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPORT & SPINE OF REHAB MCLEAN PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-04",
        "last_updated": "2011-05-06",
        "status": "A",
        "authorized_official_last_name": "GREENSTEIN",
        "authorized_official_first_name": "JAY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "240-766-0300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI",
            "identifier": "2136310",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "3846233",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF LABOR",
            "identifier": "611706800",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "7229667",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ASHN CIGNA HMO",
            "identifier": "1060259",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALLIANCE",
            "identifier": "2136310",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA PPO",
            "identifier": "672723",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MDIPA",
            "identifier": "2136310",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTIMUM CHOICE",
            "identifier": "2136310",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NCA",
            "identifier": "G746",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Speech and Language Center of Northern Virginia
• Angela Spencer, RPH
• Ricarrdo Spencer
• Brittney Lynn Spiker, BCBA
• Melissa Beth Sporn, PH.D.
• Sport Psychs LLC
• Jennifer Djorup Spyridakis
• Sally Sroge, DPT, PT
• Olivia Stanford
• Whitney Stang-Miller

• Chiropractor in MC Lean, VA
• Providers in MC Lean, VA by specialty
• Chiropractor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 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.