Spine Midwest, Inc

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

SPINE MIDWEST, INC

Practice address

200 Saint Marys Medical PLZ
Suite 301
Jefferson City, MO 65101-1604

Phone

(573) 634-4212

NPI assigned

Nov 5, 2007

Organization subpart

No

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

Authorized official

Name

William Blake Rodgers, M.D.

Title

President

Phone

(573) 634-4212

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1194220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194220800000",
    "number": "1003096306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 SAINT MARYS MEDICAL PLZ",
            "address_2": "SUITE 301",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651011604",
            "telephone_number": "573-634-4212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 SAINT MARYS MEDICAL PLZ",
            "address_2": "SUITE 301",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651011604",
            "telephone_number": "573-634-4212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPINE MIDWEST, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-05",
        "last_updated": "2007-11-05",
        "status": "A",
        "authorized_official_last_name": "RODGERS",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "BLAKE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "573-634-4212",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Multi-Specialty Clinic/Center in Jefferson City, MO
• Providers in Jefferson City, MO by specialty
• Multi-Specialty Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2007; 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.