NPIMap

Organization Active NPI

Axis Spine Clinic, LLC

  • Neurological Surgery Physician
  • Gahanna, OH
National Provider Identifier
1326714288
Registry record updated Jun 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
Legal business name
AXIS SPINE CLINIC, LLC
Practice address
800 Cross Pointe Rd Ste I
Gahanna, OH 43230-6688
Phone
(614) 468-5333
Fax
(614) 428-0899
NPI assigned
Aug 20, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2022

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

Authorized official

Name
Dr. Craig Steven Berg Jr., MDNPI 1891034708
Title
Managing Member
Phone
(614) 468-5333

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207T00000X Primary
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

800 Cross Pointe Rd Ste I
Gahanna, OH 43230-6688

Mailing address

800 Cross Pointe Rd Ste I
Gahanna, OH 43230-6688
Phone (614) 468-5333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20211202001349 OH Part B Supplier - Clinic/Group Practice 6002206224 Receives reassigned benefits from 3 practitioners
Practice locations: Gahanna, OH
O20220801002287 OH DME Supplier - Multi-Specialty - PhysicianDME Supplier - Physician - Neurosurgery 6002206224 Practice locations: Gahanna, OH

National Provider Directory

National Provider Directory

Locations

800 Cross Pointe Rd
Ste I
Gahanna, OH 43230
Phone (614) 468-5333

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1629417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654041600000",
    "number": "1326714288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 CROSS POINTE RD STE I",
            "city": "GAHANNA",
            "state": "OH",
            "postal_code": "432306688",
            "telephone_number": "614-468-5333",
            "fax_number": "614-428-0899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 CROSS POINTE RD STE I",
            "city": "GAHANNA",
            "state": "OH",
            "postal_code": "432306688",
            "telephone_number": "614-468-5333",
            "fax_number": "614-428-0899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AXIS SPINE CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-20",
        "last_updated": "2022-06-01",
        "certification_date": "2022-06-01",
        "status": "A",
        "authorized_official_last_name": "BERG",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_middle_name": "STEVEN",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "614-468-5333",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gahanna, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.