Organization Active NPI

Bayside Chiropractic, Sprague & Chiu

  • Chiropractor
  • San Carlos, CA
National Provider Identifier
1588833784
Registry record updated Feb 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC30648 Issued in CA
Legal business name
BAYSIDE CHIROPRACTIC, SPRAGUE & CHIU
Practice address
1200 Brittan Ave
San Carlos, CA 94070-3931
Phone
(650) 591-1002
NPI assigned
Feb 21, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2008

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

Authorized official

Name
Dr. Steve Sprague, DC
Title
President
Phone
(650) 591-1002

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X DC30648 CA Primary

Addresses

Primary practice location

1200 Brittan Ave
San Carlos, CA 94070-3931

Mailing address

1200 Brittan Ave
San Carlos, CA 94070-3931
Phone (650) 591-1002

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081010000732 CA Part B Supplier - Clinic/Group Practice 0547338964 Receives reassigned benefits from 1 practitioner
Practice locations: San Carlos, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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": "1203552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203552000000",
    "number": "1588833784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 BRITTAN AVE",
            "city": "SAN CARLOS",
            "state": "CA",
            "postal_code": "940703931",
            "telephone_number": "650-591-1002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 BRITTAN AVE",
            "city": "SAN CARLOS",
            "state": "CA",
            "postal_code": "940703931",
            "telephone_number": "650-591-1002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYSIDE CHIROPRACTIC, SPRAGUE & CHIU",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-21",
        "last_updated": "2008-02-21",
        "status": "A",
        "authorized_official_last_name": "SPRAGUE",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "650-591-1002",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC30648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Carlos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2008; 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.