Columbus Spine and Performance Center, LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

GA005828 Issued in GA

Legal business name

COLUMBUS SPINE AND PERFORMANCE CENTER, LLC

Practice address

1714 Manchester Expy
Columbus, GA 31904-6748

Phone

(706) 596-0909

Fax

(706) 596-0919

NPI assigned

May 15, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Gordon Leslie Stephenson Jr., D.C.NPI 1457355398

Title

Shareholder

Phone

(706) 596-0909

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.

• Gordon Leslie Stephenson Jr., D.C.

  • Chiropractor
  • Columbus, GA
  • NPI 1457355398
  NPD (past) Authorized official

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

{
    "created_epoch": "1210809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210809600000",
    "number": "1336316629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1714 MANCHESTER EXPY",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319046748",
            "telephone_number": "706-596-0909",
            "fax_number": "706-596-0919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1714 MANCHESTER EXPY",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319046748",
            "telephone_number": "706-596-0909",
            "fax_number": "706-596-0919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLUMBUS SPINE AND PERFORMANCE CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-15",
        "last_updated": "2008-05-15",
        "status": "A",
        "authorized_official_last_name": "STEPHENSON",
        "authorized_official_first_name": "GORDON",
        "authorized_official_middle_name": "LESLIE",
        "authorized_official_title_or_position": "SHAREHOLDER",
        "authorized_official_telephone_number": "706-596-0909",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "GA005828",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAGE GROUP NUMBER",
            "identifier": "GRP4198",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Columbus Rehab Center, LLC
• Columbus Shoulder Surgery & Sports Medicine LLC
• Columbus Sleep Solutions
• Columbus Specialty Hospital
• Columbus Speech & Hearing Center
• Columbus State University
• Columbus State University
• Columbus State University
• Columbus Surgical Specialists, LLC
• Columbus Urology,PC

• Chiropractor in Columbus, GA
• Providers in Columbus, GA by specialty
• Chiropractor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2008; 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.