NPIMap

Organization Active NPI

Premier Spine Group, S.C.

  • Orthopaedic Surgery of the Spine Physician
  • Stevens Point, WI
National Provider Identifier
1235962804
Registry record updated Sep 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X
Legal business name
PREMIER SPINE GROUP, S.C.
Practice address
200 Division St Ste J
Stevens Point, WI 54481-1843
Phone
(715) 544-1774
Fax
(715) 544-1772
NPI assigned
Aug 20, 2024
Last updated
Sep 1, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2024

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

Authorized official

Name
Todd A Fairchild, MDNPI 1568672525
Title
President
Phone
(715) 544-1774

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X NU
Orthopaedic Surgery of the Spine Physician 207XS0117X NU Primary
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X NU
Surgery Physician 208600000X NU
Pain Medicine Physician 208VP0000X NU

Addresses

Primary practice location

200 Division St Ste J
Stevens Point, WI 54481-1843

Mailing address

520 Vincent St
Stevens Point, WI 54481-1848
Phone (715) 544-1774

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1724112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725148800000",
    "number": "1235962804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 VINCENT ST",
            "city": "STEVENS POINT",
            "state": "WI",
            "postal_code": "544811848",
            "telephone_number": "715-544-1774",
            "fax_number": "715-544-1772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 DIVISION ST STE J",
            "city": "STEVENS POINT",
            "state": "WI",
            "postal_code": "544811843",
            "telephone_number": "715-544-1774",
            "fax_number": "715-544-1772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER SPINE GROUP, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-20",
        "last_updated": "2024-09-01",
        "certification_date": "2024-09-01",
        "status": "A",
        "authorized_official_last_name": "FAIRCHILD",
        "authorized_official_first_name": "TODD",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "715-544-1774",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stevens Point, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2024; 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.