NPIMap

Organization Active NPI

Pro Sport and Spine PLLC

  • Sports Physician Chiropractor
  • Gig Harbor, WA
National Provider Identifier
1841672433
Registry record updated Nov 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
CH60066715 Issued in WA
Legal business name
PRO SPORT AND SPINE PLLC
Practice address
5160 Borgen Blvd Ste 101
Gig Harbor, WA 98332-8809
Phone
(253) 853-4000
NPI assigned
Jun 19, 2015
Last updated
Nov 13, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2024

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

Authorized official

Name
Dr. Sean Spaulding, D.C.NPI 1922247402
Title
Part Owner
Phone
(253) 853-4000

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician Chiropractor 111NS0005X CH60066715 WA Primary
Rehabilitation Chiropractor 111NR0400X CH60071160 WA

Addresses

Primary practice location

5160 Borgen Blvd Ste 101
Gig Harbor, WA 98332-8809

Mailing address

5160 Borgen Blvd Ste 101
Gig Harbor, WA 98332-8809
Phone (253) 853-4000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170321001088 WA Part B Supplier - Clinic/Group Practice 1658656384 Receives reassigned benefits from 15 practitioners
Practice locations: Gig Harbor, WA

National Provider Directory

National Provider Directory

Locations

5160 Borgen Blvd
Ste 101
Gig Harbor, WA 98332
Phone (253) 853-4000

10516 Silverdale Way NW
Ste 110B
Silverdale, WA 98383
Phone (360) 633-8888

Practitioners & affiliated clinicians

Practitioners 28

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.

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1434672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731456000000",
    "number": "1841672433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5160 BORGEN BLVD STE 101",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983328809",
            "telephone_number": "253-853-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5160 BORGEN BLVD STE 101",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983328809",
            "telephone_number": "253-853-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRO SPORT AND SPINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-19",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A",
        "authorized_official_last_name": "SPAULDING",
        "authorized_official_first_name": "SEAN",
        "authorized_official_title_or_position": "PART OWNER",
        "authorized_official_telephone_number": "253-853-4000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "WA",
            "license": "CH60066715",
            "primary": true
        },
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "WA",
            "license": "CH60071160",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gig Harbor, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2024; 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.