Spine & Sports Medicine Center PLLC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

15561 Issued in MS

Legal business name

SPINE & SPORTS MEDICINE CENTER PLLC

Practice address

218 S Thomas St
Suite 110
Tupelo, MS 38801-5330

Phone

(662) 842-4919

Fax

(662) 842-9140

NPI assigned

Jul 23, 2006

Organization subpart

No

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

Authorized official

Name

Victor Gray, M.D.

Title

Physician

Phone

(662) 842-4919

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1153612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392681600000",
    "number": "1295756112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2439",
            "address_2": "SUITE 110",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388032439",
            "telephone_number": "662-842-4919",
            "fax_number": "662-842-9140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 S THOMAS ST",
            "address_2": "SUITE 110",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388015330",
            "telephone_number": "662-842-4919",
            "fax_number": "662-842-9140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPINE & SPORTS MEDICINE CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-23",
        "last_updated": "2014-02-18",
        "status": "A",
        "authorized_official_last_name": "GRAY",
        "authorized_official_first_name": "VICTOR",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "662-842-4919",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MS",
            "license": "15561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Barry Dwayne Spencer, PTA
• Benjamin Duke Spencer, FNP-BC
• Jason Martin Spencer, DPT
• Louise Moorefield Spencer, MD
• Kendrick Spight
• Michael Edward Spradling, CADC
• Amber St Rose
• St. Jude Hospice Mississippi, LLC
• Mary D Stacy, LMSW
• Andrea Standifer

• Physical Medicine & Rehabilitation Physician in Tupelo, MS
• Providers in Tupelo, MS by specialty
• Physical Medicine & Rehabilitation Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2014; 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.