NPIMap

Organization Active NPI

Advanced Spine and Pain PLLC

  • Orthopaedic Surgery of the Spine Physician
  • Stafford, VA
National Provider Identifier
1255695490
Registry record updated Aug 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X
License
0101243103 Issued in VA
Legal business name
ADVANCED SPINE AND PAIN PLLC
Practice address
2046 Jefferson Davis Hwy
103
Stafford, VA 22554-7276
Phone
(703) 522-2727
NPI assigned
Jul 3, 2012
Last updated
Aug 29, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2012

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

Authorized official

Name
Thomas Raley, MDNPI 1518967207
Title
Owner
Phone
(703) 522-2727

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery of the Spine Physician 207XS0117X 0101243103 VA Primary

Addresses

Primary practice location

2046 Jefferson Davis Hwy
103
Stafford, VA 22554-7276

Mailing address

PO Box 62234
Baltimore, MD 21264-2234
Phone (703) 522-2727

Other identifiers 1

IdentifierTypeStateIssuer
DQ1510OtherVARRCARE

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 42

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.

View all 42

NPI Registry JSON

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

{
    "created_epoch": "1341273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346198400000",
    "number": "1255695490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 62234",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212642234",
            "telephone_number": "703-522-2727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2046 JEFFERSON DAVIS HWY",
            "address_2": "103",
            "city": "STAFFORD",
            "state": "VA",
            "postal_code": "225547276",
            "telephone_number": "703-522-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED SPINE AND PAIN PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-03",
        "last_updated": "2012-08-29",
        "status": "A",
        "authorized_official_last_name": "RALEY",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "703-522-2727",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "VA",
            "license": "0101243103",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRCARE",
            "identifier": "DQ1510",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stafford, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 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.