NPIMap

Organization Active NPI

Pro Spine and Sport, LLC

  • Sports Physician Chiropractor
  • Central Point, OR
National Provider Identifier
1912385816
Registry record updated Oct 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
5507 Issued in OR
Legal business name
PRO SPINE AND SPORT, LLC
Practice address
62 N 3Rd St
Central Point, OR 97502-2025
Phone
(541) 727-7867
Fax
(541) 727-7868
NPI assigned
May 12, 2015
Last updated
Oct 28, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2025

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

Authorized official

Name
Corey O'NeillNPI 1023445327
Title
Owner/Physician
Phone
(541) 944-8404

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
Sports Physician Chiropractor 111NS0005X 5507 OR Primary

Addresses

Primary practice location

62 N 3Rd St
Central Point, OR 97502-2025

Mailing address

PO Box 5267
Central Point, OR 97502-0051

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150625002073 OR Part B Supplier - Clinic/Group Practice 9234440686 Receives reassigned benefits from 6 practitioners
Practice locations: Central Point, OR

National Provider Directory

National Provider Directory

Locations

62 N 3rd St
Central Point, OR 97502
Phone (541) 727-7867

943 Automation Way
#A1
Medford, OR 97504
Phone (541) 601-5062

943 Automation Way
Ste A1
Medford, OR 97504
Phone (541) 944-8404

Practitioners & affiliated clinicians

Practitioners 7

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": "1431388800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761609600000",
    "number": "1912385816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5267",
            "city": "CENTRAL POINT",
            "state": "OR",
            "postal_code": "975020051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 N 3RD ST",
            "city": "CENTRAL POINT",
            "state": "OR",
            "postal_code": "975022025",
            "telephone_number": "541-727-7867",
            "fax_number": "541-727-7868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRO SPINE AND SPORT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-12",
        "last_updated": "2025-10-28",
        "certification_date": "2025-10-28",
        "status": "A",
        "authorized_official_last_name": "O'NEILL",
        "authorized_official_first_name": "COREY",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "541-944-8404"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "OR",
            "license": "5507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Central Point, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2025; 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.