Organization Active NPI

Synergy Spine and Orthopedic Surgery Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Warren, MI
National Provider Identifier
1104179878
Registry record updated Dec 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
SYNERGY SPINE AND ORTHOPEDIC SURGERY CENTER, LLC
Practice address
5504 E 12 Mile Rd
Warren, MI 48092-4684
Phone
(586) 838-2035
NPI assigned
Oct 18, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2023

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

Authorized official

Name
Kathryn Mary PringNPI 1912179979
Title
Vice-President of Operations
Phone
(586) 439-6314

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

5504 E 12 Mile Rd
Warren, MI 48092-4684

Mailing address

5504 West 12 Mile Road
Warren, MI 48092
Phone (586) 838-2035

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130517000559 MI Part B Supplier - Ambulatory Surgical Center 2264679885 Receives reassigned benefits from 7 practitioners
Practice locations: Warren, MI

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Synergy Spine and Orthopedic Surgery Center LLCCCN 23C0001123
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D2054397Synergy Spine & Orthopedic Surgery Center, LLC5504 East 12 Mile Road, Warren, MI 48092Certificate of waiverFeb 19, 2027

National Provider Directory

National Provider Directory

Locations

5504 E 12 Mile Rd
Warren, MI 48092
Phone (586) 439-6242

Practitioners & affiliated clinicians

Practitioners 8

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": "1350518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703116800000",
    "number": "1104179878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5504 WEST 12 MILE ROAD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "48092",
            "telephone_number": "586-838-2035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5504 E 12 MILE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480924684",
            "telephone_number": "586-838-2035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SYNERGY SPINE AND ORTHOPEDIC SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-18",
        "last_updated": "2023-12-21",
        "certification_date": "2023-12-21",
        "status": "A",
        "authorized_official_last_name": "PRING",
        "authorized_official_first_name": "KATHRYN",
        "authorized_official_middle_name": "MARY",
        "authorized_official_title_or_position": "VICE-PRESIDENT OF OPERATIONS",
        "authorized_official_telephone_number": "586-439-6314"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.