NPIMap

Organization Active NPI

Optimal Spine & Health Center Inc

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Gilbert, AZ
National Provider Identifier
1386835965
Registry record updated Nov 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
Legal business name
OPTIMAL SPINE & HEALTH CENTER INC
Practice address
5656 S Power Rd Ste 132
Gilbert, AZ 85295-8490
Phone
(480) 688-4006
NPI assigned
Aug 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2018

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

Authorized official

Name
Dr. Kevin Fox, DCNPI 1972562783
Title
President
Phone
(480) 985-0040

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X 5716 AZ
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2081P2900X Primary

Addresses

Primary practice location

5656 S Power Rd Ste 132
Gilbert, AZ 85295-8490

Mailing address

5656 S Power Rd Ste 132
Gilbert, AZ 85295-8490

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050929000553 AZ Part B Supplier - Clinic/Group Practice 2466487392 Receives reassigned benefits from 7 practitioners
Practice locations: Gilbert, AZ

National Provider Directory

National Provider Directory

Locations

5656 S Power Rd
Ste 132
Gilbert, AZ 85295
Phone (480) 279-5270

7141 W Thomas Rd
Unit 101
Phoenix, AZ 85033

Practitioners & affiliated clinicians

Practitioners 12

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": "1186444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1541980800000",
    "number": "1386835965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5656 S POWER RD STE 132",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852958490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5656 S POWER RD STE 132",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852958490",
            "telephone_number": "480-688-4006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMAL SPINE & HEALTH CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-07",
        "last_updated": "2018-11-12",
        "status": "A",
        "authorized_official_last_name": "FOX",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "480-985-0040",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "5716",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2018; 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.