NPIMap

Organization Active NPI

Advanced Sport and Spine Chiropractic LLC

  • Chiropractor
  • Pleasant Hill, OR
National Provider Identifier
1962092031
Registry record updated Jan 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
ADVANCED SPORT AND SPINE CHIROPRACTIC LLC
Practice address
85203 Jasper Park Rd
Pleasant Hill, OR 97455-9773
Phone
(541) 852-8806
NPI assigned
Jan 22, 2021
Last updated
Jan 25, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2021

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

Authorized official

Name
Justin Coryell, DCNPI 1538708011
Title
Owner
Phone
(541) 852-8806

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X NU Primary

Addresses

Primary practice location

85203 Jasper Park Rd
Pleasant Hill, OR 97455-9773

Mailing address

85203 Jasper Park Rd
Pleasant Hill, OR 97455-9773
Phone (541) 852-8806

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1611273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611532800000",
    "number": "1962092031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85203 JASPER PARK RD",
            "city": "PLEASANT HILL",
            "state": "OR",
            "postal_code": "974559773",
            "telephone_number": "541-852-8806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85203 JASPER PARK RD",
            "city": "PLEASANT HILL",
            "state": "OR",
            "postal_code": "974559773",
            "telephone_number": "541-852-8806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED SPORT AND SPINE CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-22",
        "last_updated": "2021-01-25",
        "certification_date": "2021-01-25",
        "status": "A",
        "authorized_official_last_name": "CORYELL",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-852-8806",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pleasant Hill, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2021; 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.