Organization Active NPI

Yourspine LLC

  • Chiropractor
  • Kensington, MD
National Provider Identifier
1700140464
Registry record updated May 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
01268 Issued in MD
Legal business name
YOURSPINE LLC
Practice address
10605 Concord St
Suite 502
Kensington, MD 20895-2504
Phone
(240) 242-3266
NPI assigned
Jun 27, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 29, 2013

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

Authorized official

Name
Sheila AmonNPI 1144399726
Title
Chiropractor
Phone
(240) 242-3266

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 01268 MD Primary

Addresses

Primary practice location

10605 Concord St
Suite 502
Kensington, MD 20895-2504

Mailing address

10605 Concord St
Suite 502
Kensington, MD 20895-2504
Phone (240) 242-3266

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120822000058 DC Part B Supplier - Clinic/Group Practice 1557518891 Receives reassigned benefits from 1 practitioner
Practice locations: Kensington, MD

National Provider Directory

National Provider Directory

Locations

10605 Concord St
Ste 502
Kensington, MD 20895
Phone (240) 242-3266

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": "1340755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1369785600000",
    "number": "1700140464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10605 CONCORD ST",
            "address_2": "SUITE 502",
            "city": "KENSINGTON",
            "state": "MD",
            "postal_code": "208952504",
            "telephone_number": "240-242-3266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10605 CONCORD ST",
            "address_2": "SUITE 502",
            "city": "KENSINGTON",
            "state": "MD",
            "postal_code": "208952504",
            "telephone_number": "240-242-3266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOURSPINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-27",
        "last_updated": "2013-05-29",
        "status": "A",
        "authorized_official_last_name": "AMON",
        "authorized_official_first_name": "SHEILA",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "240-242-3266"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MD",
            "license": "01268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kensington, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2013; 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.