SHERIDAN SPINE AND SPORTS MEDICINE (BRANDON KELLEY D.C. P.C.) NPI 1831675479

Chiropractor (Sports Physician) in Sheridan, WY

Organization Chiropractor Sports Physician

About SHERIDAN SPINE AND SPORTS MEDICINE (BRANDON KELLEY D.C. P.C.)

Sheridan Spine And Sports Medicine (brandon Kelley D.c. P.c.) is a provider established in Sheridan, Wyoming specializing in chiropractor. The NPI number of Sheridan Spine And Sports Medicine (brandon Kelley D.c. P.c.) is 1831675479 and was assigned on July 2018. The practitioner's primary taxonomy code is 111NS0005X with license number 779 (WY). The provider is registered as an organization and their NPI record was last updated 2 years ago. Sheridan Spine And Sports Medicine (brandon Kelley D.c. P.c.) operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The provider's is doing business as Sheridan Spine And Sports Medicine. The authorized official of this NPI record is Brandon Kelley D.c. (Physician)

NPI

1831675479

Provider NameSHERIDAN SPINE AND SPORTS MEDICINE (BRANDON KELLEY D.C. P.C.)
Provider Location Address1156 N MAIN ST SHERIDAN, WY 82801
Provider Mailing Address1156 N MAIN ST SHERIDAN, WY 82801
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Other Organization NameSHERIDAN SPINE AND SPORTS MEDICINE
Other Name TypeDoing Business As (3)
Enumeration Date07-17-2018
Last Update Date07-17-2018

Primary Taxonomy

Taxonomy Code111NS0005X
ClassificationChiropractor
TypeChiropractic Providers
SpecializationSports Physician
License No.779
License StateWY
Taxonomy DescriptionA sports chiropractor is uniquely trained to provide care and treatment of injuries or illness resulting from sports and physical fitness activities. Doctors of Chiropractic with the Diplomate American Chiropractic Board of Sports Physicians (DACBSP) or the Certified Chiropractic Sports Physician (CCSP), sport specialty certifications from the American Chiropractic Board of Sports Physicians, have advanced training in the assessment, management and rehabilitation of sports related injuries. Extremity care, rehabilitation and soft tissue procedures are common skills utilized by these doctors. The specialty training covers a broad spectrum from the pediatric athlete to professional and Olympic athletes, and everything in between, using a variety of techniques and modalities.

Business Address

SHERIDAN SPINE AND SPORTS MEDICINE
1156 N MAIN ST
SHERIDAN, WY
ZIP 82801
Phone: (307) 763-4556

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Mailing Address

SHERIDAN SPINE AND SPORTS MEDICINE
1156 N MAIN ST
SHERIDAN, WY
ZIP 82801
Phone: (307) 763-4556

Authorized Official

Authorized Official Name BRANDON KELLEY D.C.
Authorized Official TitlePHYSICIAN
Authorized Official Phone(307) 763-4556

Group Taxonomy


193400000X SINGLE SPECIALTY GROUP - This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Other Providers at the same location


The following 2 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1154862951 BRANDON KELLEY
Individual
Chiropractor (Independent Medical Examiner)1156 N MAIN ST
SHERIDAN, WY 82801
(970) 925-1808
1699827766 WENDY J WOOD NEESON FAMILY NURSE PRACTIT
Individual
Nurse Practitioner (Family)1156 N MAIN ST
SHERIDAN, WY 82801
(307) 751-0645

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.