Interventional Spine & Sports Institute

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

20628 Issued in MS

Legal business name

INTERVENTIONAL SPINE & SPORTS INSTITUTE

Practice address

105 Asbury Cir Ste B
Hattiesburg, MS 39402-1397

Phone

(601) 296-2552

Fax

(601) 296-2554

NPI assigned

Aug 24, 2009

Last updated

Jun 30, 2010By 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. Brian S. Trussell, M.D.NPI 1972633923

Title

Owner

Phone

(601) 296-2552

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/13202/brand/1/csg/1/fhir/r4

Practitioners 3

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.

• Brian Scott Trussell, MD

  • Physical Medicine & Rehabilitation Physician
  • Hattiesburg, MS
  • NPI 1972633923
  Medicare reassignment Care Compare group NPD Authorized official
• Kathryn Amanda Arnold, NP-C

  • Adult Health Nurse Practitioner
  • McComb, MS
  • NPI 1730587767
  Medicare reassignment Care Compare group NPD
• Kelli P. Mooney, FNP

  • Family Nurse Practitioner
  • Hattiesburg, MS
  • NPI 1205288495
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1251072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277856000000",
    "number": "1073746152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 17708",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394047708",
            "telephone_number": "601-296-2552",
            "fax_number": "601-296-2552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 ASBURY CIR STE B",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394021397",
            "telephone_number": "601-296-2552",
            "fax_number": "601-296-2554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERVENTIONAL SPINE & SPORTS INSTITUTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-24",
        "last_updated": "2010-06-30",
        "status": "A",
        "authorized_official_last_name": "TRUSSELL",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-296-2552",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MS",
            "license": "20628",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carley Lakenn Inmon
• Innovative Prosthetics LLC
• Insight Behavioral Health (Stacy Williams)
• Institute for Spinal Pain Treatment
• Integrated Health & Wellness Solutions
• Luis A Irizzary, MD
• Latonio Johwayne Irvin
• Olivia Hogan Ismail, LCSW
• Aaron Israel, DPM
• J and C Transportation Agency, LLC

• Physical Medicine & Rehabilitation Physician in Hattiesburg, MS
• Providers in Hattiesburg, MS by specialty
• Physical Medicine & Rehabilitation Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2010; 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.