NPIMap

Organization Active NPI

Sheppard Spine & Sports Clinic

  • Chiropractor
  • Solana Beach, CA
National Provider Identifier
1982859526
Registry record updated Nov 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
16059 Issued in CA
Legal business name
SHEPPARD SPINE & SPORTS CLINIC
Practice address
634 Stevens Ave
Solana Beach, CA 92075-2422
Phone
(858) 350-6290
Fax
(858) 350-6775
NPI assigned
Nov 24, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2008

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

Authorized official

Name
Dr. Kenny R Sheppard, D.C.NPI 1609934934
Title
Owner
Phone
(858) 350-6290

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
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X 16059 CA Primary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X 15278 CA

Addresses

Primary practice location

634 Stevens Ave
Solana Beach, CA 92075-2422

Mailing address

634 Stevens Ave
Solana Beach, CA 92075-2422
Phone (858) 350-6290

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 9

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

NPI Registry JSON

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

{
    "created_epoch": "1227484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1227484800000",
    "number": "1982859526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "634 STEVENS AVE",
            "city": "SOLANA BEACH",
            "state": "CA",
            "postal_code": "920752422",
            "telephone_number": "858-350-6290",
            "fax_number": "858-350-6775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "634 STEVENS AVE",
            "city": "SOLANA BEACH",
            "state": "CA",
            "postal_code": "920752422",
            "telephone_number": "858-350-6290",
            "fax_number": "858-350-6775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHEPPARD SPINE & SPORTS CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-24",
        "last_updated": "2008-11-24",
        "status": "A",
        "authorized_official_last_name": "SHEPPARD",
        "authorized_official_first_name": "KENNY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "858-350-6290",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "16059",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "15278",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Solana Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2008; 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.