Organization Active NPI

Spinal Care Plus PA

  • Neurology Chiropractor
  • Panama City, FL
National Provider Identifier
1093862401
Registry record updated Jun 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology ChiropractorTaxonomy code 111NN0400X
License
CH7828 Issued in FL
Legal business name
SPINAL CARE PLUS PA
Practice address
714 E 4TH St
Panama City, FL 32401-3757
Phone
(850) 784-7800
Fax
(850) 784-7825
NPI assigned
Jan 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2008

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

Authorized official

Name
Dr. Mike Lee Colvin, DC
Title
Chiropractor Neurology
Phone
(850) 784-7800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111NN0400X CH7828 FL Primary

Addresses

Primary practice location

714 E 4TH St
Panama City, FL 32401-3757

Mailing address

714 E 4TH St
Panama City, FL 32401-3757
Phone (850) 784-7800

Other identifiers 1

IdentifierTypeStateIssuer
K1828MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080605000283 FL Part B Supplier - Clinic/Group Practice 3274627807 Receives reassigned benefits from 1 practitioner
Practice locations: Panama City, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212624000000",
    "number": "1093862401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "714 E 4TH ST",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324013757",
            "telephone_number": "850-784-7800",
            "fax_number": "850-784-7825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "714 E 4TH ST",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324013757",
            "telephone_number": "850-784-7800",
            "fax_number": "850-784-7825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPINAL CARE PLUS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-05",
        "last_updated": "2008-06-05",
        "status": "A",
        "authorized_official_last_name": "COLVIN",
        "authorized_official_first_name": "MIKE",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "CHIROPRACTOR NEUROLOGY",
        "authorized_official_telephone_number": "850-784-7800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111NN0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Neurology",
            "state": "FL",
            "license": "CH7828",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "K1828",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Panama City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2008; 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.