MEDICARE: ULTIMATE EDGE SPORTS CHIROPRACTIC LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor

General Provider Information

NPI Number	:	1548127426
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ULTIMATE EDGE SPORTS CHIROPRACTIC LLC

Provider Business Mailing Address
First Line	:	20701 N SCOTTSDALE RD STE 107
Second Line	:	BOX 511
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85255
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	17060 N THOMPSON PEAK PKWY STE 100
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85255-2558
Country	:	US
Telephone Number	:	609-970-1382
Fax Number	:

Authorized Official
Title or Position	:	CHIROPRACTOR
Name	:	AMY RICHMOND
Credential	:	DC, ATC
Telephone Number	:	480-269-5820

Provider Enumeration Date	:	01/05/2026
Last Update Date	:	01/13/2026

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