Missouri Spine Institute, LLC

Primary specialty

Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X

License

LC0926793 Issued in MO

Legal business name

MISSOURI SPINE INSTITUTE, LLC

Practice address

1616 Southridge Dr
Ste 202
Jefferson City, MO 65109-5677

Phone

(573) 635-0401

Fax

(573) 635-6715

NPI assigned

Nov 5, 2008

Organization subpart

No

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

Authorized official

Name

John D. Spears, DONPI 1043315385

Title

Owner

Phone

(573) 635-0401

Specialties & licenses 1

Addresses

Practitioners 1

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.

• John D Spears, D.O.

  • Orthopaedic Surgery of the Spine Physician
  • Jefferson City, MO
  • NPI 1043315385
  Authorized official Same address or phone

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

{
    "created_epoch": "1225843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480550400000",
    "number": "1265686125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1616 SOUTHRIDGE DR",
            "address_2": "STE 202",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651095677",
            "telephone_number": "573-635-0401",
            "fax_number": "573-635-6715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1616 SOUTHRIDGE DR",
            "address_2": "STE 202",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651095677",
            "telephone_number": "573-635-0401",
            "fax_number": "573-635-6715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSOURI SPINE INSTITUTE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-05",
        "last_updated": "2016-12-01",
        "status": "A",
        "authorized_official_last_name": "SPEARS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "573-635-0401",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "MO",
            "license": "LC0926793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Orthopaedic Surgery of the Spine Physician in Jefferson City, MO
• Providers in Jefferson City, MO by specialty
• Orthopaedic Surgery of the Spine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2016; 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.