Active Spine and Sports Clinic

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC 29365 Issued in CA

Legal business name

ACTIVE SPINE AND SPORTS CLINIC

Practice address

3151 Olin Ave
Ste 103
San Jose, CA 95117-1635

Phone

(408) 247-8812

Fax

(408) 247-8814

NPI assigned

May 15, 2007

Last updated

Jun 16, 2008By 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. Colle Hunt Jr., D.C.NPI 1891788204

Title

Owner

Phone

(408) 247-8812

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Colle Hunt Jr., DC

  • Chiropractor
  • San Jose, CA
  • NPI 1891788204
  NPD (past) Authorized official

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213574400000",
    "number": "1619183084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3151 OLIN AVE",
            "address_2": "STE 103",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951171635",
            "telephone_number": "408-247-8812",
            "fax_number": "408-247-8814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3151 OLIN AVE",
            "address_2": "STE 103",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951171635",
            "telephone_number": "408-247-8812",
            "fax_number": "408-247-8814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVE SPINE AND SPORTS CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-15",
        "last_updated": "2008-06-16",
        "status": "A",
        "authorized_official_last_name": "HUNT",
        "authorized_official_first_name": "COLLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "408-247-8812",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC 29365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in San Jose, CA
• Providers in San Jose, CA by specialty
• Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2008; 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.