TRI-STATE SPORT AND SPINE, PLLC (NPI# 1578921359) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1578921359 |
Entity Type | Organization |
Organization Name | TRI-STATE SPORT AND SPINE, PLLC |
Practice Address |
100 South Broad Street 1800 Philadelphia PA 19110 |
Mailing Address |
110 Wharton St Philadelphia PA 19147-5425 |
Practice Telephone | 2159889503 |
Practice Fax Number | 2159889533 |
Mailing Telephone | 6097600386 |
Enumeration Date | 2016-02-08 |
Last Update Date | 2016-02-08 |
Authorized Official Name | MICHAEL DOUGHERTY (OWNER) |
Authorized Official Telephone | 6097600386 |
Authorized Official Credential | DC |
Is Organization Subpart | Y |
Parent Organization Name | TRI-STATE SPORT AND SPINE, PLLC |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 111N00000X | Chiropractor | DC010688 | PA | Chiropractic Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1902200876 | Tri-state Sport and Spine, Pllc | Chiropractor | 9331 Old Bustleton Ave, Suite 101, Philadelphia, PA 19115-4204 | 2014-10-21 |
Street Address |
100 SOUTH BROAD STREET 1800 |
City | PHILADELPHIA |
State | PA |
Zip Code | 19110 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1023177144 | Joseph J. Peters Institute | Community/Behavioral Health | 100 South Broad Street, 17th Floor, Philadelphia, PA 19110 | 2006-12-06 |
1104481316 | Alyssa Levy-dougherty | Social Worker | 100 South Broad Street, 17th Floor, Philadelphia, PA 19110-9997 | 2019-05-02 |
1073749123 | Philadelphia Spine and Wellness Cntr. | Chiropractor | 100 South Broad Street, Suite 1800 B, Philadelphia, PA 19110 | 2009-06-03 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1518332543 | Thomas Fredrick Haworth | Psychologist | 100 South Broad St, Suite 1700, Philadelphia, PA 19110 | 2015-12-02 |
1588076178 | Hanel Ariel Choi | Dentist | 100 S. Broad St. Suite 1530, Philadelphia, PA 19110 | 2014-05-29 |
1104093004 | Erin Hadley | Psychologist | 100 S. Broad St., Suite 915, Philadelphia, PA 19110 | 2008-05-11 |
1407053846 | Kimberly Davis | Chiropractor | 100 S Broad Street, Suite 1800b, Philadelphia, PA 19110 | 2007-06-29 |
1366997223 | Jenna Courtney Rosenau | Social Worker | 100 S Broad Street, Suite 1920, Philadelphia, PA 19110 | 2016-08-22 |
1164802708 | Jordan Levy | Social Worker | 100 S. Broad Street, Suite 1515, Philadelphia, PA 19110 | 2015-06-08 |
1528485828 | Boston Medical Group Pennsylvania, P.C. | Urology | 100 S. Broad Street, Suite 2136, Philadelphia, PA 19110 | 2014-03-25 |
1821434788 | Kathleen Fragale | Physical Therapist | 100 S Broad Street, Suite 1800b, Philadelphia, PA 19110 | 2013-05-20 |
1871864223 | Andrew Rittenhouse | Chiropractor | 100 S Broad Street, Suite 1800b, Philadelphia, PA 19110 | 2012-01-17 |
1255757373 | Elizabeth Earnshaw | Counselor | 100 S Broad St Ste 1304, Philadelphia, PA 19110-1004 | 2014-03-13 |
Find all providers in zip 19110 |
Taxonomy Code | 111N00000X |
Grouping | Chiropractic Providers |
Classification | Chiropractor |
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1124628540 | Citywide North, PC | Chiropractor | 2304-a North Broad Street, Philadelphia, PA 19132-4563 | 2020-10-26 |
1598313488 | Dev Avinash Rajhansa | Chiropractor | 101 W Allens Ln, Philadelphia, PA 19119-4101 | 2019-09-03 |
1861059859 | Joshua James Kramarenko | Chiropractor | 1608 Walnut St Ste 601, Philadelphia, PA 19103-5447 | 2019-05-24 |
1306409024 | Danielle Louise Walsh | Chiropractor | 3500 Scotts Ln Ste 215, Philadelphia, PA 19129-1836 | 2019-04-18 |
1952868804 | Yoon Sang Song | Chiropractor | 6115 Woodland Ave, Philadelphia, PA 19142-2418 | 2019-02-27 |
1104381011 | Anthony James Havens Jr. | Chiropractor | 6006 Chestnut St Fl 1, Philadelphia, PA 19139-3044 | 2019-02-05 |
1750851390 | Philadelphia Pain and Neurology Institute, LLC | Chiropractor | 1528 Walnut Street Suite 620, Philadelphia, PA 19102 | 2018-11-27 |
1710467626 | Darin Mathew Daniel | Chiropractor | 2216 W Passyunk Ave, Philadelphia, PA 19145-3318 | 2018-08-20 |
1780184952 | Chelsea Ann Mclane | Chiropractor | 430 Green Ln, Philadelphia, PA 19128-3304 | 2018-02-14 |
1881193860 | Pa Pain and Rehab | Chiropractor | 6325 Woodland Avenue, Philadelphia, PA 19142 | 2018-02-06 |
Find all providers in PHILADELPHIA |
City | PHILADELPHIA |
Zip Code | 19110 |
Please comment or provide details below to improve the information on TRI-STATE SPORT AND SPINE, PLLC.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.