Organization Active NPI

Blacksphere Chiropractic, PC

  • Chiropractor
  • San Diego, CA
National Provider Identifier
1679443253
Registry record updated Nov 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
BLACKSPHERE CHIROPRACTIC, PC
Practice address
12396 World Trade Dr Ste 210
San Diego, CA 92128-3788
Phone
(619) 431-1082
NPI assigned
Nov 7, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2025

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

Authorized official

Name
Kristi Black, DCNPI 1447129085
Title
Ceo
Phone
(714) 390-2842

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
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

12396 World Trade Dr Ste 210
San Diego, CA 92128-3788

Mailing address

12396 World Trade Dr Ste 210
San Diego, CA 92128-3788
Phone (619) 431-1082

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251120003421 CA Part B Supplier - Clinic/Group Practice 1456843101 Receives reassigned benefits from 1 practitioner
Practice locations: San Diego, CA

National Provider Directory

National Provider Directory

Locations

12396 World Trade Dr
Ste 210
San Diego, CA 92128
Phone (619) 431-1082

Practitioners & affiliated clinicians

Practitioners 1

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": "1762473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762473600000",
    "number": "1679443253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12396 WORLD TRADE DR STE 210",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921283788",
            "telephone_number": "619-431-1082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12396 WORLD TRADE DR STE 210",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921283788",
            "telephone_number": "619-431-1082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLACKSPHERE CHIROPRACTIC, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-11-07",
        "last_updated": "2025-11-07",
        "certification_date": "2025-11-07",
        "status": "A",
        "authorized_official_last_name": "BLACK",
        "authorized_official_first_name": "KRISTI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "714-390-2842",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2025; 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.