Spine & Nerve Diagnostic Center

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

Legal business name

SPINE & NERVE DIAGNOSTIC CENTER

Practice address

4200 Douglas Blvd
Granite Bay, CA 95746-5902

Phone

(916) 722-5325

NPI assigned

Nov 7, 2019

Organization subpart

Yes

Parent organization

SPINE & NERVE DIAGNOSTIC CENTERAs reported in NPPES

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

Authorized official

Name

Vinay Moola Reddy

Title

President and Ceo

Phone

(916) 772-5325

Specialties & licenses 1

Addresses

Tax ID family

Spine Nerve Diagnostic Ctr3 organizations share this tax ID, including this one

Part of

Spine Nerve Diagnostic Ctr

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Spine & Nerve Diagnostic Center

  • Physical Medicine & Rehabilitation Physician
  • Davis, CA
  • NPI 1467016303
  NPD tax ID
• Spine & Nerve Diagnostic Center

  • Physical Medicine & Rehabilitation Physician
  • Lincoln, CA
  • NPI 1528928421
  NPD tax ID

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

{
    "created_epoch": "1573084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1573084800000",
    "number": "1144865726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1528 EUREKA RD STE 103",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956613047",
            "telephone_number": "916-772-5325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 DOUGLAS BLVD",
            "city": "GRANITE BAY",
            "state": "CA",
            "postal_code": "957465902",
            "telephone_number": "916-722-5325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPINE & NERVE DIAGNOSTIC CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SPINE & NERVE DIAGNOSTIC CENTER",
        "enumeration_date": "2019-11-07",
        "last_updated": "2019-11-07",
        "status": "A",
        "authorized_official_last_name": "REDDY",
        "authorized_official_first_name": "VINAY",
        "authorized_official_middle_name": "MOOLA",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "916-772-5325"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Coelithia Nicole Sosa, PA
• South Placer Fire District
• Cassie Justine Spalding-Dias, M.D.
• Tiana Spano
• Serina Sperduto
• Amanda Splinter, NP
• Veronica Steiner
• Samantha Alexis Stethem
• Dwight Raymond Stickney, M.D.
• Leslie Stone, M.A. LMFT

• Physical Medicine & Rehabilitation Physician in Granite Bay, CA
• Providers in Granite Bay, CA by specialty
• Physical Medicine & Rehabilitation Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 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.