Dynamic Spine & Joint Center

Primary specialty

Rehabilitation ChiropractorTaxonomy code 111NR0400X

License

2011000036 Issued in MO

Legal business name

DYNAMIC SPINE & JOINT CENTER

Practice address

1100 SE Century Dr
Ste D
Lees Summit, MO 64081-3284

Phone

(816) 655-2162

NPI assigned

Oct 23, 2011

Organization subpart

No

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

Authorized official

Name

Nicole Dierking, DC

Title

Owner

Phone

(636) 253-0761

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1319328000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378857600000",
    "number": "1649556630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 SE CENTURY DR",
            "address_2": "STE D",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640813284",
            "telephone_number": "816-655-2162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 SE CENTURY DR",
            "address_2": "STE D",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640813284",
            "telephone_number": "816-655-2162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYNAMIC SPINE & JOINT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-23",
        "last_updated": "2013-09-11",
        "status": "A",
        "authorized_official_last_name": "DIERKING",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "636-253-0761",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Rehabilitation",
            "state": "MO",
            "license": "2011000036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jerod Duncan
• Rian B Dunkin, LPC, MA
• Jamie Durner, NBC-HWC
• Mary Beth Duryea, M.D.
• Ciara Dawn Dutton, OTR/L
• Robin Leslie Dyson, M.D.
• Nicholas Patrick Earley, DPT
• Eastport Chiropractic, LLC
• Eastridge Family Dental, PC
• Marissa Lynn Ebeling, LPC

• Rehabilitation Chiropractor in Lees Summit, MO
• Providers in Lees Summit, MO by specialty
• Rehabilitation Chiropractor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 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.