Southwest Spine and Pain Care Specialists LLC

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

Legal business name

SOUTHWEST SPINE AND PAIN CARE SPECIALISTS LLC

Practice address

630 E 1400 N
Suite 135
Logan, UT 84341-2534

Phone

(435) 656-2424

Fax

(535) 787-8149

NPI assigned

Apr 2, 2016

Organization subpart

No

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

Authorized official

Name

Jon Obtay, MD

Title

President

Phone

(435) 656-2424

Specialties & licenses 1

Addresses

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

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1459555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474934400000",
    "number": "1134582570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "652 S MEDICAL CENTER DR",
            "address_2": "SUITE 110",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847907049",
            "telephone_number": "435-656-2424",
            "fax_number": "535-787-8149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 E 1400 N",
            "address_2": "SUITE 135",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843412534",
            "telephone_number": "435-656-2424",
            "fax_number": "535-787-8149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST SPINE AND PAIN CARE SPECIALISTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-02",
        "last_updated": "2016-09-27",
        "status": "A",
        "authorized_official_last_name": "OBTAY",
        "authorized_official_first_name": "JON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "435-656-2424",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jake Daniel Sorensen, D.D.S.
• Tracy Dennis Sorensen
• Janae J Sorenson, LCSW
• Amanda Sotelo Chavez
• South Pointe Surgical Center
• Kimberly Elizabeth Souza, MD
• Madison Spainhower, DPT
• Kimberly Spear, SSW
• Specialty Sales & Service
• Specialty Sales & Service

• Pain Medicine (Anesthesiology) Physician in Logan, UT
• Providers in Logan, UT by specialty
• Pain Medicine (Anesthesiology) Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.