Ivy Spine & Orthopedics, LLC

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

Legal business name

IVY SPINE & ORTHOPEDICS, LLC

Practice address

2532 Capital Medical Blvd
Tallahassee, FL 32308-4424

Phone

(850) 628-7679

Fax

(850) 257-8099

NPI assigned

Oct 5, 2020

Organization subpart

Yes

Parent organization

IVY SPINE & ORTHOPEDICS, LLCAs reported in NPPES

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

Authorized official

Name

Jennifer Gates

Title

Practice Manager

Phone

(850) 628-7679

Specialties & licenses 1

Addresses

Other names 1

• Ivy Spine and Orthopedics, LLC Doing business as

Part of

Ivy Spine Orthopedics LLC

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Ivy Spine & Orthopedics, LLC

  • Orthopaedic Surgery Physician
  • Panama City, FL
  • NPI 1215433644
  NPPES parent name

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

{
    "created_epoch": "1601856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630972800000",
    "number": "1215534011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2532 CAPITAL MEDICAL BLVD",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323084424",
            "telephone_number": "850-628-7679",
            "fax_number": "850-257-8099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2532 CAPITAL MEDICAL BLVD",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323084424",
            "telephone_number": "850-628-7679",
            "fax_number": "850-257-8099"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "742 Harrison Ave",
            "address_purpose": "LOCATION",
            "city": "Panama City",
            "state": "FL",
            "postal_code": "324012524",
            "country_code": "US",
            "telephone_number": "850-628-7679",
            "fax_number": "850-257-8099",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "IVY SPINE & ORTHOPEDICS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "IVY SPINE & ORTHOPEDICS, LLC",
        "enumeration_date": "2020-10-05",
        "last_updated": "2021-09-07",
        "certification_date": "2021-09-07",
        "status": "A",
        "authorized_official_last_name": "GATES",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "850-628-7679"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ivy Spine and Orthopedics, LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Ivy Spine and Orthopedics, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Brooke Issitt
• Tanisha Ivery-McLeroy, M.ED., RMHCI
• Darrell Keith Ivey, MSW, LMHC, CEAP, SAP
• Katie Lynn Ivey
• Timika Ivory
• Narayan Krishnamoorthy Iyer, M.D.
• Hitomi Izawa
• J H Harvey Co LLC
• J Lucas Koberda, MD, PHD, Neurology, LLC
• J R F Chiropractic

• Orthopaedic Surgery Physician in Tallahassee, FL
• Providers in Tallahassee, FL by specialty
• Orthopaedic Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2021; 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.