Premier Spine Care, P.a.

Primary specialty

Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X

Legal business name

PREMIER SPINE CARE, P.A.

Doing business as

Premier Spine Care Overland Park

Practice address

7840 W 165TH St Ste 280
Overland Park, KS 66223-3022

Phone

(913) 322-2700

Fax

(913) 322-7890

NPI assigned

Mar 18, 2022

Organization subpart

No

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

Authorized official

Name

John M Ciccarelli, MDNPI 1205884889

Title

Physician

Phone

(913) 322-2700

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Premier Spine Care Overland Park Doing business as

Practitioners 2

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

• John M Ciccarelli, M.D.

  • Orthopaedic Surgery of the Spine Physician
  • Lenexa, KS
  • NPI 1205884889
  NPD Authorized official
• Adrian P Jackson, M.D.

  • Orthopaedic Surgery of the Spine Physician
  • Overland Park, KS
  • NPI 1114985355
  NPD

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

{
    "created_epoch": "1647561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647561600000",
    "number": "1376292318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26250",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662256250",
            "telephone_number": "913-322-2700",
            "fax_number": "913-322-7890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7840 W 165TH ST STE 280",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662233022",
            "telephone_number": "913-322-2700",
            "fax_number": "913-322-7890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER SPINE CARE, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-18",
        "last_updated": "2022-03-18",
        "certification_date": "2022-03-18",
        "status": "A",
        "authorized_official_last_name": "CICCARELLI",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "913-322-2700",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "0430147",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "0431121",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Premier Spine Care Overland Park",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Orthopaedic Surgery of the Spine Physician in Overland Park, KS
• Providers in Overland Park, KS by specialty
• Orthopaedic Surgery of the Spine Physician in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2022; 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.