Center for Advanced Interventional Spine Treatment PLC

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

License

JE069312 Issued in MI

Legal business name

CENTER FOR ADVANCED INTERVENTIONAL SPINE TREATMENT PLC

Practice address

12662 Riley St Ste 120
Holland, MI 49424-8023

Phone

(616) 796-6430

Fax

(616) 786-4324

NPI assigned

Oct 20, 2009

Last updated

Jan 8, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. John Easa, MD

Title

Sole Member

Phone

(616) 796-6430

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1255996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262908800000",
    "number": "1235465683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12662 RILEY ST STE 120",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494248023",
            "telephone_number": "616-796-6430",
            "fax_number": "616-786-4324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12662 RILEY ST STE 120",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494248023",
            "telephone_number": "616-796-6430",
            "fax_number": "616-786-4324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR ADVANCED INTERVENTIONAL SPINE TREATMENT PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-20",
        "last_updated": "2010-01-08",
        "status": "A",
        "authorized_official_last_name": "EASA",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "616-796-6430",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "MI",
            "license": "JE069312",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3441763",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jill Maree Cavazos, COTA/L
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• Joshua Adam Cebula, D.C
• Jodi Lynn Cech
• Center for Family Development
• Donald Morris Chaffee III, M.D.
• Sara Beloglavec Chaffee, MD
• Abigail Grace Chamberlain
• David W. Chamness, MD

• Pain Medicine (Anesthesiology) Physician in Holland, MI
• Providers in Holland, MI by specialty
• Pain Medicine (Anesthesiology) Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2010; 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.