NPIMap

Organization Active NPI

Spine & Sports Injury Center, P.C.

  • Chiropractor
  • Boston, MA
National Provider Identifier
1891840922
Registry record updated Aug 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
966 Issued in MA
Legal business name
SPINE & SPORTS INJURY CENTER, P.C.
Practice address
209 Columbus Ave
Boston, MA 02116-5109
Phone
(617) 247-2300
Fax
(617) 936-4196
NPI assigned
Jan 25, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2023

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

Authorized official

Name
Dr. Richard Lawrence Green, DC
Title
President
Phone
(617) 877-7754

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X 966 MA Primary

Addresses

Primary practice location

209 Columbus Ave
Boston, MA 02116-5109

Mailing address

1 Dalton St Unit 3404
Boston, MA 02115-3187
Phone (617) 877-7754

Other identifiers 1

IdentifierTypeStateIssuer
Y49258OtherMAMEDICARE GROUP #

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

209 Columbus Ave
Lowr
Boston, MA 02116
Phone (617) 247-2300

209 Columbus Ave
Boston, MA 02116
Phone (617) 247-2300

Practitioners & affiliated clinicians

Practitioners 24

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691452800000",
    "number": "1891840922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 DALTON ST UNIT 3404",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021153187",
            "telephone_number": "617-877-7754",
            "fax_number": "617-936-4196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 COLUMBUS AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021165109",
            "telephone_number": "617-247-2300",
            "fax_number": "617-936-4196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPINE & SPORTS INJURY CENTER, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-25",
        "last_updated": "2023-08-08",
        "certification_date": "2020-11-02",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "LAWRENCE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "617-877-7754",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "MA",
            "license": "966",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP #",
            "identifier": "Y49258",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2023; 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.