Baltimore Spine Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

A1413 Issued in MD

Legal business name

BALTIMORE SPINE CENTER, LLC

Practice address

1300 Bellona Ave
Building D
Lutherville, MD 21093-5465

Phone

(410) 828-4789

Fax

(410) 337-6999

NPI assigned

Jul 13, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Kyle Moore

Title

Administrator

Phone

(410) 828-4789

Specialties & licenses 1

Addresses

Locations

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.

• Reginald J Davis, M.D.

  • Neurological Surgery Physician
  • Fort Myers, FL
  • NPI 1992721021
  NPD (past)

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1316962244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 BELLONA AVE",
            "address_2": "BUILDING D",
            "city": "LUTHERVILLE",
            "state": "MD",
            "postal_code": "210935465",
            "telephone_number": "410-828-4789",
            "fax_number": "410-337-6999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 BELLONA AVE",
            "address_2": "BUILDING D",
            "city": "LUTHERVILLE",
            "state": "MD",
            "postal_code": "210935465",
            "telephone_number": "410-828-4789",
            "fax_number": "410-337-6999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BALTIMORE SPINE CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "KYLE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "410-828-4789",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "MD",
            "license": "A1413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sukumar Balachandran, D.M.D
• Margaret F Balacki, MSN-CRNP/PMH
• Todd Baldanza, M.D.
• Billie J Baldwin
• Vincent Lorenzo Ball
• Bare Necessities, LTD
• Carol A. Barlow, L.C.P.C.
• Adonaca Barrett
• Kelsey Morgan Barron
• Gina Wertalik Basey, PSY.D.

• Ambulatory Surgical Clinic/Center in Lutherville, MD
• Providers in Lutherville, MD by specialty
• Ambulatory Surgical Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.