North Regional Spine, Corporation

Primary specialty

Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X

License

052966 Issued in GA

Legal business name

NORTH REGIONAL SPINE, CORPORATION

Practice address

314 N Broad St
Suite 340
Winder, GA 30680-2191

Phone

(678) 661-3196

Fax

(678) 661-3196

NPI assigned

Oct 26, 2012

Organization subpart

No

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

Authorized official

Name

Mr. Miguel Alexander Jimenez, M.D.

Title

Ceo

Phone

(770) 374-3714

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1351209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351209600000",
    "number": "1194078287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3390 PEACHTREE RD NE",
            "address_2": "SUITE 450",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303261157",
            "telephone_number": "770-374-3714",
            "fax_number": "770-438-1477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "314 N BROAD ST",
            "address_2": "SUITE 340",
            "city": "WINDER",
            "state": "GA",
            "postal_code": "306802191",
            "telephone_number": "678-661-3196",
            "fax_number": "678-661-3196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH REGIONAL SPINE, CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-26",
        "last_updated": "2012-10-26",
        "status": "A",
        "authorized_official_last_name": "JIMENEZ",
        "authorized_official_first_name": "MIGUEL",
        "authorized_official_middle_name": "ALEXANDER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "770-374-3714",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "GA",
            "license": "052966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Trang Nguyen
• Kelsey Nipper, DNP, FNP-BC
• Shanesha Nixon
• North Broad Family Medicine
• North Georgia Eye Care LLC
• Destiny Nunnery
• Alexandria Odum, FNP-C
• Oguguo C. Okoye, M.D.
• Denisa Carmen Olarescu, PHARMD
• Gbenga Omotayo

• Orthopaedic Surgery of the Spine Physician in Winder, GA
• Providers in Winder, GA by specialty
• Orthopaedic Surgery of the Spine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2012; 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.