NPIMap

Organization Active NPI

SBR Sports Chiropractic, LLC

  • Chiropractor
  • Medford, MA
National Provider Identifier
1710255534
Registry record updated Dec 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3186 Issued in MA
Legal business name
SBR SPORTS CHIROPRACTIC, LLC
Practice address
151 Mystic Ave
Suite 1
Medford, MA 02155-4632
Phone
(617) 930-6205
NPI assigned
Dec 7, 2011
Last updated
Dec 28, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2011

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

Authorized official

Name
Dr. Laura Jansen, D.CNPI 1629245337
Title
Owner/Chiropractor
Phone
(617) 930-6205

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3186 MA Primary

Addresses

Primary practice location

151 Mystic Ave
Suite 1
Medford, MA 02155-4632

Mailing address

151 Mystic Ave
Suite 1
Medford, MA 02155-4632

National Provider Directory

National Provider Directory

Locations

151 Mystic Ave
Ste 1
Medford, MA 02155
Phone (617) 930-6205

27 Normac Rd
Woburn, MA 01801
Phone (617) 930-6205

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1323216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1325030400000",
    "number": "1710255534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 MYSTIC AVE",
            "address_2": "SUITE 1",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021554632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 MYSTIC AVE",
            "address_2": "SUITE 1",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021554632",
            "telephone_number": "617-930-6205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SBR SPORTS CHIROPRACTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-07",
        "last_updated": "2011-12-28",
        "status": "A",
        "authorized_official_last_name": "JANSEN",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "OWNER/CHIROPRACTOR",
        "authorized_official_telephone_number": "617-930-6205",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MA",
            "license": "3186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2011; 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.