Axis Spine LLC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

Legal business name

AXIS SPINE LLC

Practice address

1519 3Rd St SE Ste 101
Puyallup, WA 98372-3742

Phone

(909) 659-1852

NPI assigned

Oct 3, 2024

Organization subpart

No

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

Authorized official

Name

Kenneth Nwosu, MDNPI 1548543853

Title

Spine Surgeon

Phone

(909) 659-1852

Specialties & licenses 1

Addresses

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/15112/brand/2/csg/1/fhir/r4

Practitioners 1

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

• Kenneth Nwosu

  • Orthopaedic Surgery Physician
  • Torrance, CA
  • NPI 1548543853
  NPD Authorized official

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

{
    "created_epoch": "1727913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727913600000",
    "number": "1134948458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 N 39TH CT",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980561624",
            "telephone_number": "909-659-1852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1519 3RD ST SE STE 101",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983723742",
            "telephone_number": "909-659-1852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AXIS SPINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-03",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A",
        "authorized_official_last_name": "NWOSU",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "SPINE SURGEON",
        "authorized_official_telephone_number": "909-659-1852",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Avenue Home LLC
• Marc L Aversa, MD
• Alicia Avis, LMP
• Ian Keaupuni Awai, PA-C
• Awareness Adult Family Home Care LLC
• Deniz Aydinel, DMD
• Jessica Azcarraga, RN
• Uchechukwu Nwamaka Azikiwe, PHARMD
• Venus Azimi, D.O
• Georgina J Azzam

• Medical Specialty Clinic/Center in Puyallup, WA
• Providers in Puyallup, WA by specialty
• Medical Specialty Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2024; 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.