Organization Active NPI

Interventional Spine Institute of Florida, PA

  • Specialist
  • Rockledge, FL
National Provider Identifier
1154739258
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
60952 Issued in FL
Legal business name
INTERVENTIONAL SPINE INSTITUTE OF FLORIDA, PA
Practice address
389 Commerce Pkwy
Suite 120
Rockledge, FL 32955-4202
Phone
(321) 733-0064
Fax
(321) 733-7970
NPI assigned
Aug 1, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Authorized official

Name
Brian C Dowdell, M.D.
Title
Owner/Ceo/President
Phone
(321) 733-0064

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 60952 FL Primary
Durable Medical Equipment & Medical Supplies 332B00000X 60952 FL

Addresses

Primary practice location

389 Commerce Pkwy
Suite 120
Rockledge, FL 32955-4202

Mailing address

308 S Harbor City Blvd
Suite a
Melbourne, FL 32901-1500
Phone (321) 733-0064

Other identifiers 6

IdentifierTypeStateIssuer
1225060338OtherFLNPI GROUP
1326453143OtherFLNPI-DME-MELBOURNE
1639101744OtherFLNPI INDIVIDUAL
10708014OtherFLCAQH
K5708OtherFLMEDICARE GROUP
ME76009OtherFLMEDICAL LICENSE

Other names 1

  • Spine, Orthopedics and Rehabilitation Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1406851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1154739258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 S HARBOR CITY BLVD",
            "address_2": "SUITE A",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329011500",
            "telephone_number": "321-733-0064",
            "fax_number": "321-733-7970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "389 COMMERCE PKWY",
            "address_2": "SUITE 120",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329554202",
            "telephone_number": "321-733-0064",
            "fax_number": "321-733-7970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERVENTIONAL SPINE INSTITUTE OF FLORIDA, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-01",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "DOWDELL",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER/CEO/PRESIDENT",
        "authorized_official_telephone_number": "321-733-0064",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "60952",
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "FL",
            "license": "60952",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI GROUP",
            "identifier": "1225060338",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI-DME-MELBOURNE",
            "identifier": "1326453143",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI INDIVIDUAL",
            "identifier": "1639101744",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "10708014",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "K5708",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "ME76009",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Spine, Orthopedics and Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rockledge, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.