Montana Sport and Spine LLC

Primary specialty

Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X

License

10381 Issued in MT

Legal business name

MONTANA SPORT AND SPINE LLC

Doing business as

Bozeman Sport and Spine LLC

Practice address

925 Highland Blvd, Suite 1130
Bozeman Sport and Spine LLC
Bozeman, MT 59715-6900

Phone

(406) 522-9067

Fax

(406) 522-9074

NPI assigned

Oct 9, 2006

Last updated

Jul 23, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Bradley L. Aylor, M.D.NPI 1477645570

Title

Proprieter

Phone

(406) 522-9067

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Bozeman Sport and Spine LLC Doing business as

Medicare fee-for-service enrollment

Enrolled in MT

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Bradley Aylor, M.D.

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Bozeman, MT
  • NPI 1477645570
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1160352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374537600000",
    "number": "1013004241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 HIGHLAND BLVD, SUITE 1130",
            "address_2": "MONTANA SPORT AND SPINE LLC",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597156900",
            "telephone_number": "406-522-9067",
            "fax_number": "406-522-9074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 HIGHLAND BLVD, SUITE 1130",
            "address_2": "BOZEMAN SPORT AND SPINE LLC",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597156900",
            "telephone_number": "406-522-9067",
            "fax_number": "406-522-9074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTANA SPORT AND SPINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-09",
        "last_updated": "2013-07-23",
        "status": "A",
        "authorized_official_last_name": "AYLOR",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "PROPRIETER",
        "authorized_official_telephone_number": "406-522-9067",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "MT",
            "license": "10381",
            "primary": true
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "000099205",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DC7699",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bozeman Sport and Spine LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Bozeman, MT
• Providers in Bozeman, MT by specialty
• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.