Organization Active NPI

Sports and Family Chiropractic

  • Sports Physician Chiropractor
  • Anaheim, CA
National Provider Identifier
1508900838
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
Legal business name
SPORTS AND FAMILY CHIROPRACTIC
Practice address
1842 W Lincoln Ave
Suite F
Anaheim, CA 92801-5426
Phone
(714) 956-2225
Fax
(714) 956-5350
NPI assigned
Feb 19, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Dr. Gary Bradford Wright, D.C.NPI 1073644811
Title
Ceo President
Phone
(714) 956-2225

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 CA Primary

Addresses

Primary practice location

1842 W Lincoln Ave
Suite F
Anaheim, CA 92801-5426

Mailing address

1842 W Lincoln Ave
Suite F
Anaheim, CA 92801-5426
Phone (714) 956-2225

Other identifiers 3

IdentifierTypeStateIssuer
DC0230590MedicaidCA
DC0230590OtherCASERVICE LINE PIN
DC023059OtherCASTATE LICENSE

National Provider Directory

National Provider Directory
Tax ID family
Gary B Wright Chiropractic Corporation2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1842 W Lincoln Ave
Ste F
Anaheim, CA 92801
Phone (714) 956-2225

Practitioners & affiliated clinicians

Practitioners 1

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": "1171843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1508900838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1842 W LINCOLN AVE",
            "address_2": "SUITE F",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928015426",
            "telephone_number": "714-956-2225",
            "fax_number": "714-956-5350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1842 W LINCOLN AVE",
            "address_2": "SUITE F",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928015426",
            "telephone_number": "714-956-2225",
            "fax_number": "714-956-5350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPORTS AND FAMILY CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-19",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "WRIGHT",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "BRADFORD",
        "authorized_official_title_or_position": "CEO PRESIDENT",
        "authorized_official_telephone_number": "714-956-2225",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Sports Physician",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DC0230590",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SERVICE LINE PIN",
            "identifier": "DC0230590",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "DC023059",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.