NPIMap

Organization Active NPI

Sport Spine & Wellness, PLLC

  • Sports Physician Chiropractor
  • St George, UT
National Provider Identifier
1942541222
Registry record updated Mar 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
8536048-1202 Issued in UT
Legal business name
SPORT SPINE & WELLNESS, PLLC
Practice address
1664 S Dixie Dr
Ste. F-103
St George, UT 84770-7327
Phone
(435) 703-9676
NPI assigned
Mar 11, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2013

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

Authorized official

Name
Dr. Mikel Richter, D.C.
Title
Owner
Phone
(435) 703-9676

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111NS0005X 8536048-1202 UT Primary

Addresses

Primary practice location

1664 S Dixie Dr
Ste. F-103
St George, UT 84770-7327

Mailing address

1664 S Dixie Dr
Ste. F-103
St George, UT 84770-7327
Phone (435) 703-9676

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1362960000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362960000000",
    "number": "1942541222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1664 S DIXIE DR",
            "address_2": "STE. F-103",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847707327",
            "telephone_number": "435-703-9676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1664 S DIXIE DR",
            "address_2": "STE. F-103",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847707327",
            "telephone_number": "435-703-9676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPORT SPINE & WELLNESS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-11",
        "last_updated": "2013-03-11",
        "status": "A",
        "authorized_official_last_name": "RICHTER",
        "authorized_official_first_name": "MIKEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "435-703-9676",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Sports Physician",
            "state": "UT",
            "license": "8536048-1202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St George, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2013; 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.