Microspine Surgery Center Defuniak Springs LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

1155 Issued in FL

Legal business name

MICROSPINE SURGERY CENTER DEFUNIAK SPRINGS LLC

Practice address

101 Microspine Way
Defuniak Springs, FL 32435-6323

Phone

(850) 892-6001

Fax

(850) 892-4212

NPI assigned

May 23, 2006

Organization subpart

Yes

Parent organization

MICROSPINE INCAs reported in NPPES

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

Authorized official

Name

Angel D Barber

Title

Administrator

Phone

(850) 892-6001

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Anthony R. Mork, M.D.

  • Orthopaedic Surgery of the Spine Physician
  • Irvine, CA
  • NPI 1851338073
  NPD

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191888000000",
    "number": "1306891718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 MICROSPINE WAY",
            "city": "DEFUNIAK SPRINGS",
            "state": "FL",
            "postal_code": "324356323",
            "telephone_number": "850-892-6001",
            "fax_number": "850-892-4212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 MICROSPINE WAY",
            "city": "DEFUNIAK SPRINGS",
            "state": "FL",
            "postal_code": "324356323",
            "telephone_number": "850-892-6001",
            "fax_number": "850-892-4212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICROSPINE SURGERY CENTER DEFUNIAK SPRINGS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MICROSPINE INC",
        "enumeration_date": "2006-05-23",
        "last_updated": "2007-10-09",
        "status": "A",
        "authorized_official_last_name": "BARBER",
        "authorized_official_first_name": "ANGEL",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "850-892-6001"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "FL",
            "license": "1155",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "6B7",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stacie M McIntosh Heintzelman, RBT
• Ryan Meadows, RN
• Lauren F Medford
• Microspine Orthopedic Physicians LLC
• Microspine Physicians Group LLC
• Alexis Rae Millender, RBT
• Melvia D. Mims, DPT
• Julia Montagnet
• Lindsay Moore, RBT
• Nicole Frances Morgan

• Ambulatory Surgical Clinic/Center in Defuniak Springs, FL
• Providers in Defuniak Springs, FL by specialty
• Ambulatory Surgical Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2007; 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.