Southern Spine and Sport

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

SOUTHERN SPINE AND SPORT

Practice address

2200 Ozark Hwy
Enterprise, AL 36330-8231

Phone

(850) 860-0884

NPI assigned

Dec 18, 2023

Organization subpart

No

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

Authorized official

Name

Russell Salmon, DPTNPI 1982037339

Title

Owner

Phone

(850) 860-0884

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Russell Salmon, AT

  • Physical Therapist
  • Dothan, AL
  • NPI 1982037339

  AL, Physical Therapist

  Medicare reassignment Care Compare group NPD Authorized official
• Charles Jason West, DPT

  • Physical Therapist
  • Enterprise, AL
  • NPI 1922275726

  AL, Physical Therapist

  Medicare reassignment Care Compare group NPD
• Kaitlin Moore

  • Physical Therapist
  • Enterprise, AL
  • NPI 1790483667

  AL

  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1702857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702857600000",
    "number": "1235907338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 OZARK HWY",
            "city": "ENTERPRISE",
            "state": "AL",
            "postal_code": "363308231",
            "telephone_number": "850-860-0884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 OZARK HWY",
            "city": "ENTERPRISE",
            "state": "AL",
            "postal_code": "363308231",
            "telephone_number": "850-860-0884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN SPINE AND SPORT",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-18",
        "last_updated": "2023-12-18",
        "certification_date": "2023-12-18",
        "status": "A",
        "authorized_official_last_name": "SALMON",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "850-860-0884",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Southeastern ENT, P.C.
• Southern Alabama Physicians,LLP
• Southern Care Inc
• Southern Hearing Associates, Inc.
• Southern Sleep Clinics LLC
• Kaye Spear
• Specialists of Enterprise, Inc
• John Stanton, DO
• Channing Jamal Starks
• State of Alabama

• All providers in Enterprise, AL
• Physical Therapist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.