Microspine Physicians Group LLC

Primary specialty

Sports Medicine (Internal Medicine) PhysicianTaxonomy code 207RS0010X

Legal business name

MICROSPINE PHYSICIANS GROUP LLC

Practice address

101 Microspine Way
Defuniak Springs, FL 32435-6323

Phone

(850) 892-6001

Fax

(850) 892-4212

NPI assigned

May 24, 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

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191888000000",
    "number": "1356396774",
    "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 PHYSICIANS GROUP LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MICROSPINE INC",
        "enumeration_date": "2006-05-24",
        "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": "207RS0010X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER (NONPAR) NU",
            "identifier": "34912",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nia McGowan
• Stacie M McIntosh Heintzelman, RBT
• Ryan Meadows, RN
• Lauren F Medford
• Microspine Orthopedic Physicians LLC
• Microspine Surgery Center Defuniak Springs LLC
• Alexis Rae Millender, RBT
• Melvia D. Mims, DPT
• Julia Montagnet
• Lindsay Moore, RBT

• Sports Medicine (Internal Medicine) Physician in Defuniak Springs, FL
• Providers in Defuniak Springs, FL by specialty
• Sports Medicine (Internal Medicine) Physician 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.