Spine Center of PA LLC

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

Legal business name

SPINE CENTER OF PA LLC

Practice address

2374 Village Common Dr Ste 100
Erie, PA 16506-7201

Phone

(814) 833-7246

NPI assigned

Dec 31, 2019

Last updated

Dec 31, 2019By 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

Anish Patel, MDNPI 1508814849

Title

Owner

Phone

(301) 620-0012

Specialties & licenses 2

Addresses

Locations

Practitioners 2

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.

• Anish Sharad Patel, MD, MBA

  • Interventional Pain Medicine Physician
  • Frederick, MD
  • NPI 1508814849
  Authorized official Same address or phone
• Noli Punzalan

  • Nurse Practitioner
  • Fayetteville, NC
  • NPI 1023597697
  NPD (past)

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

{
    "created_epoch": "1577750400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1577750400000",
    "number": "1104465681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3060 WILLIAMS DR STE 510",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220314648",
            "telephone_number": "703-789-1929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2374 VILLAGE COMMON DR STE 100",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165067201",
            "telephone_number": "814-833-7246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPINE CENTER OF PA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-31",
        "last_updated": "2019-12-31",
        "certification_date": "2019-12-31",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "ANISH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "301-620-0012",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Antoinette Spencer, LCSW
• Shavel C Spencer
• Monica Lynn Sperzel
• Ken Spicher
• Hannah Spiess
• Brian Andrew Spinks, DO
• Jeffrey R. Spires, D.O.
• Dorothy L Spitzer, PSY.D.
• Jessica Spitzer, PHARMD
• Megan Spizarny, PA-C

• Interventional Pain Medicine Physician in Erie, PA
• Providers in Erie, PA by specialty
• Interventional Pain Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2019; 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.