Surgical Spine Partners, LLC

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

Legal business name

SURGICAL SPINE PARTNERS, LLC

Practice address

5005 W Royal LN
Ste 196
Irving, TX 75063-1996

Phone

(817) 485-5100

NPI assigned

May 22, 2013

Organization subpart

No

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

Authorized official

Name

Charles C Neff

Title

Director

Phone

(817) 485-5100

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1369180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479427200000",
    "number": "1053757633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 204469",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753204469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5005 W ROYAL LN",
            "address_2": "STE 196",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750631996",
            "telephone_number": "817-485-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGICAL SPINE PARTNERS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-22",
        "last_updated": "2016-11-18",
        "status": "A",
        "authorized_official_last_name": "NEFF",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "817-485-5100"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2016; 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.