Provance Chiropractic Sports and Wellness, L.L.C.

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

License

1508 Issued in LA

Legal business name

PROVANCE CHIROPRACTIC SPORTS AND WELLNESS, L.L.C.

Practice address

2007 Clearview Pkwy
Metairie, LA 70001-2404

Phone

(504) 456-9296

NPI assigned

May 15, 2015

Organization subpart

No

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

Authorized official

Name

James E Rizer, DCNPI 1538398268

Title

Co-Owner

Phone

(504) 456-9296

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• James Elliot Rizer, D.C.

  • Chiropractor
  • Metairie, LA
  • NPI 1538398268
  Medicare reassignment NPD Authorized official
• Michelle Marie Le Blanc, LMT

  • Massage Therapist
  • Metairie, LA
  • NPI 1912418518
  NPD (past)
• Phillip Anthony Lirette I, LMT

  • Massage Therapist
  • Metairie, LA
  • NPI 1427563469
  NPD (past)
• Vince Stadelman

  • Chiropractor
  • Metairie, LA
  • NPI 1548652209
  NPD (past)

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

{
    "created_epoch": "1431648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431648000000",
    "number": "1669850152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2007 CLEARVIEW PKWY",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700012404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2007 CLEARVIEW PKWY",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700012404",
            "telephone_number": "504-456-9296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVANCE CHIROPRACTIC SPORTS AND WELLNESS, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-15",
        "last_updated": "2015-05-15",
        "status": "A",
        "authorized_official_last_name": "RIZER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "504-456-9296",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Sports Physician",
            "state": "LA",
            "license": "1508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mallory Privitt
• Stephanie Hope Procell, PHD
• Alison M Proctor, P-LPC
• Proniche Medical LLC
• Provance Chiropractic Sport, Family & Rehab
• Gerry G Provance, D.C.
• Randy Provensal, CRNA
• Curtis D Prowell Jr., M.D.
• Anthony G. Pruett, MD
• Psyched LLC

• Sports Physician Chiropractor in Metairie, LA
• Providers in Metairie, LA by specialty
• Sports Physician Chiropractor in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2015; 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.