Spine and Sports Insitute, LLC

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

Legal business name

SPINE AND SPORTS INSITUTE, LLC

Practice address

9325 Upland LN N
Suite 230
Maple Grove, MN 55369-4200

Phone

(763) 315-0466

Fax

(763) 315-0884

NPI assigned

Dec 27, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Jennifer Lee Lachner

Title

Office Manager

Phone

(763) 315-0466

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1198713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1730363607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9325 UPLAND LN N",
            "address_2": "SUITE 230",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553694200",
            "telephone_number": "763-315-0466",
            "fax_number": "763-315-0884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9325 UPLAND LN N",
            "address_2": "SUITE 230",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553694200",
            "telephone_number": "763-315-0466",
            "fax_number": "763-315-0884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPINE AND SPORTS INSITUTE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-27",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "LACHNER",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "763-315-0466",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Sports Physician",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; 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.