Petersburg Spine & Sport Inc

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038011323 Issued in IL

Legal business name

PETERSBURG SPINE & SPORT INC

Doing business as

Petersburg Spine & Sport

Practice address

115 E Douglas Ave
Petersburg, IL 62675-1558

Phone

(217) 632-7599

NPI assigned

Feb 6, 2009

Last updated

Jan 5, 2015By 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. Michael Gensler, DCNPI 1114164498

Title

Chiropractor

Phone

(217) 632-7599

Specialties & licenses 1

Addresses

Other names 1

• Petersburg Spine & Sport Doing business as

Practitioners 2

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.

• Michael Gensler, D.C.

  • Chiropractor
  • Petersburg, IL
  • NPI 1114164498
  Authorized official Same address or phone
• John Charles Curry, D.C.

  • Chiropractor
  • Petersburg, IL
  • NPI 1811385180
  NPD (past)

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

{
    "created_epoch": "1233878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420416000000",
    "number": "1639318173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 E DOUGLAS AVE",
            "city": "PETERSBURG",
            "state": "IL",
            "postal_code": "626751558",
            "telephone_number": "217-632-7599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 E DOUGLAS AVE",
            "city": "PETERSBURG",
            "state": "IL",
            "postal_code": "626751558",
            "telephone_number": "217-632-7599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETERSBURG SPINE & SPORT INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-06",
        "last_updated": "2015-01-05",
        "status": "A",
        "authorized_official_last_name": "GENSLER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "217-632-7599",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038011323",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Petersburg Spine & Sport",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tracy Ann Muller, MS SLP CCC
• Clara Munyer, SLP-CCC
• David D Newton, M.D.
• Dana Yvette Ogle, PTA
• Petersburg Pharmacy, Inc
• Porta Comm. Unit District 202
• Potter Pharmacy Inc (Potter Drug Inc)
• Emilie J Redding, M.D.
• Delores J Ring, LCPC
• Ashley Nichol Sanders

• Chiropractor in Petersburg, IL
• Providers in Petersburg, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2015; 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.