Genesis Chiropractic Spine and Sports Center

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

License

CHR.0006922 Issued in CO

Legal business name

GENESIS CHIROPRACTIC SPINE AND SPORTS CENTER

Practice address

7940 S University Blvd, Suite 100
Centennial, CO 80122

Phone

(760) 449-7641

NPI assigned

May 1, 2013

Last updated

May 1, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Clyde Johnson, DC

Title

Doctor/Owner

Phone

(760) 449-7641

Specialties & licenses 2

Addresses

Tax ID family

Genesis Chiropractic Spine and Sports Center2 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.

• Genesis Chiropractic Spine Ctr

  dba Genesis Wellness Clinic

  • Primary Care Clinic/Center
  • Greenwood Village, CO
  • NPI 1821488842
  NPD tax ID

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

{
    "created_epoch": "1367366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367366400000",
    "number": "1588009880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7940 S UNIVERSITY BLVD STE 100",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801225104",
            "telephone_number": "760-449-7641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7940 S UNIVERSITY BLVD, SUITE 100",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "80122",
            "telephone_number": "760-449-7641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS CHIROPRACTIC SPINE AND SPORTS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-01",
        "last_updated": "2013-05-01",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "CLYDE",
        "authorized_official_title_or_position": "DOCTOR/OWNER",
        "authorized_official_telephone_number": "760-449-7641",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "CHR.0006922",
            "primary": false
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Sports Physician",
            "state": "CO",
            "license": "CHR.0006922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Douglas Jule Geistert, P.T.
• Biniam Taddesse Gemeda
• Sarah Gemmell, MA, LPC, NCC
• Tonya Genazzi, AU.D.
• Dennis P Genereux, MD
• Genesis Reference Laboratories, LLC
• Sydney Genovese
• Gentle Giants Therapy and Consulting Center
• Gentle Hearts 3 LLC (Gentle Hearts 3 Assisted Living)
• Karin J George, MS PT

• Sports Physician Chiropractor in Centennial, CO
• Providers in Centennial, CO by specialty
• Sports Physician Chiropractor in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2013; 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.