Executive Spine Surgery

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

License

003005 Issued in NY

Legal business name

EXECUTIVE SPINE SURGERY

Practice address

657 Willow Grove St Ste 402
Hackettstown, NJ 07840

Phone

(908) 452-5612

NPI assigned

Aug 28, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Carl J Spivak, MDNPI 1316042989

Title

Neurosurgeon

Phone

(908) 452-5612

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Carl James Spivak, M.D.

  • Neurological Surgery Physician
  • Newton, NJ
  • NPI 1316042989
  NPD (past) Authorized official

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

{
    "created_epoch": "1472342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472342400000",
    "number": "1063968360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "657 WILLOW GROVE ST STE 402",
            "city": "HACKETTSTOWN",
            "state": "NJ",
            "postal_code": "078401868",
            "telephone_number": "908-452-5612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "657 WILLOW GROVE ST STE 402",
            "city": "HACKETTSTOWN",
            "state": "NJ",
            "postal_code": "07840",
            "telephone_number": "908-452-5612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXECUTIVE SPINE SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-28",
        "last_updated": "2016-08-28",
        "status": "A",
        "authorized_official_last_name": "SPIVAK",
        "authorized_official_first_name": "CARL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "NEUROSURGEON",
        "authorized_official_telephone_number": "908-452-5612",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neurological Surgery",
            "state": "NY",
            "license": "003005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ennoble Hospice NJ LLC
• Era Medical
• Eric L. Gross, MD, PC
• Cherrielyn Escono-Quiambao, APN
• Donna Sara Etkins, LCSW
• Eyedox
• Ann Falbo, M.D.
• Roberta Rosen Fallig, PH.D
• Family Chiropractic Works LLC
• Family Focused Foot & Ankle Inc

• Neurological Surgery Physician in Hackettstown, NJ
• Providers in Hackettstown, NJ by specialty
• Neurological Surgery Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 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.