Dallas Joint and Spine Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

DALLAS JOINT AND SPINE CENTER, LLC

Practice address

17051 Dallas Pkwy Ste 100
Addison, TX 75001-7102

Phone

(817) 846-5815

NPI assigned

Dec 1, 2022

Last updated

Dec 1, 2022By 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

Dr. Khalid Yousuf, MD

Title

Medical Director

Phone

(817) 846-5815

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1356051213. Details of each certification follow.

• CCN 45C0451272 Ambulatory surgical center · Active · Name & address match · Details

Ambulatory surgical center certification: CCN 45C0451272

Legal name

DALLAS JOINT AND SPINE CENTER LLC

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Dec 29, 2023

Last certification

Dec 29, 2023

Ownership / control type

Proprietary

Facility address

17051 Dallas Parkway Suite 100
Addison, TX 75001

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 3

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.

• Michael R. Mullens, MD

  • Anesthesiology Physician
  • Dallas, TX
  • NPI 1437304805
  NPD
• Matthew Rowley, MD

  • Anesthesiology Physician
  • Fort Worth, TX
  • NPI 1093954190
  NPD
• Dominique Cormier, APRN

  • Family Nurse Practitioner
  • Duncanville, TX
  • NPI 1033990692
  NPD (past)

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

{
    "created_epoch": "1669852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669852800000",
    "number": "1356051213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17051 DALLAS PKWY STE 100",
            "city": "ADDISON",
            "state": "TX",
            "postal_code": "750017102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17051 DALLAS PKWY STE 100",
            "city": "ADDISON",
            "state": "TX",
            "postal_code": "750017102",
            "telephone_number": "817-846-5815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DALLAS JOINT AND SPINE CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-01",
        "last_updated": "2022-12-01",
        "certification_date": "2022-12-01",
        "status": "A",
        "authorized_official_last_name": "YOUSUF",
        "authorized_official_first_name": "KHALID",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "817-846-5815",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cwida, Inc
• Karolyn Dailey, APRN
• Dallas Center for Advanced Depression Treatments
• Dallas County Mental Health & Mental Retardation Center (Metrocare Pharmacy at Midway)
• Dallas Dermatology Partners, PLLC
• Dallas Sci Recovery Inc
• Victoria Dang, MS, LPC-A
• Johan Daniel
• Davenport Diagnostic and Treatment Center, Inc
• David Barnett, MD PA

• Ambulatory Surgical Clinic/Center in Addison, TX
• Providers in Addison, TX by specialty
• Ambulatory Surgical Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 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; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.