Prime Ortho & Spine LLC

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

Legal business name

PRIME ORTHO & SPINE LLC

Practice address

342 Hamburg Tpke Ste 209
Wayne, NJ 07470-2166

Phone

(954) 751-4490

NPI assigned

Sep 11, 2026

Organization subpart

No

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

Authorized official

Name

Shatina Cannon

Title

Administrator

Phone

(954) 751-4490

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1789084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789084800000",
    "number": "1306756275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 W SAMPLE RD STE 318",
            "city": "DEERFIELD BEACH",
            "state": "FL",
            "postal_code": "330641342",
            "telephone_number": "954-751-4490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "342 HAMBURG TPKE STE 209",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074702166",
            "telephone_number": "954-751-4490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME ORTHO & SPINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-09-11",
        "last_updated": "2026-09-11",
        "certification_date": "2026-09-11",
        "status": "A",
        "authorized_official_last_name": "CANNON",
        "authorized_official_first_name": "SHATINA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "954-751-4490"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Orthopaedic Surgery Physician in Wayne, NJ
• Providers in Wayne, NJ by specialty
• Orthopaedic Surgery Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.