Organization Active NPI

Smith Sports Chiropractic and Wellness, Inc.

  • Sports Physician Chiropractor
  • Long Beach, CA
National Provider Identifier
1669180394
Registry record updated Nov 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
Legal business name
SMITH SPORTS CHIROPRACTIC AND WELLNESS, INC.
Practice address
3816 Woodruff Ave # 210
Long Beach, CA 90808-2147
Phone
(562) 653-4079
NPI assigned
Nov 11, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2022

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

Authorized official

Name
Dr. Anthony Smith, DCNPI 1609161454
Title
Chiropractic
Phone
(562) 715-4833

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111NS0005X Primary

Addresses

Primary practice location

3816 Woodruff Ave # 210
Long Beach, CA 90808-2147

Mailing address

3816 Woodruff Ave # 210
Long Beach, CA 90808-2147

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230608003048 CA Part B Supplier - Clinic/Group Practice 5395102123 Receives reassigned benefits from 1 practitioner
Practice locations: Long Beach, CA

National Provider Directory

National Provider Directory

Locations

3816 Woodruff Ave
Ste 210
Long Beach, CA 90808
Phone (562) 653-4079

Practitioners & affiliated clinicians

Practitioners 2

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": "1668124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668124800000",
    "number": "1669180394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3816 WOODRUFF AVE # 210",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908082147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3816 WOODRUFF AVE # 210",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908082147",
            "telephone_number": "562-653-4079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMITH SPORTS CHIROPRACTIC AND WELLNESS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-11",
        "last_updated": "2022-11-11",
        "certification_date": "2022-11-11",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "CHIROPRACTIC",
        "authorized_official_telephone_number": "562-715-4833",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Sports Physician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2022; 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.