The Spine Institute at Orthopaedic Associates PL

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

Legal business name

THE SPINE INSTITUTE AT ORTHOPAEDIC ASSOCIATES PL

Practice address

1034 Mar Walt Dr
Suite 310
Fort Walton Beach, FL 32547-6645

Phone

(850) 797-6027

Fax

(850) 797-6027

NPI assigned

Nov 5, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Kornelis A Poelstra, MDNPI 1467496828

Title

Physician

Phone

(850) 797-6027

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Kornelis Poelstra, M.D.

  • Orthopaedic Surgery of the Spine Physician
  • Las Vegas, NV
  • NPI 1467496828
  NPD (past) Authorized official

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

{
    "created_epoch": "1257379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1338595200000",
    "number": "1396072765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1034 MAR WALT DR",
            "address_2": "SUITE 310",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476645",
            "telephone_number": "850-797-6027",
            "fax_number": "850-797-6027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1034 MAR WALT DR",
            "address_2": "SUITE 310",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476645",
            "telephone_number": "850-797-6027",
            "fax_number": "850-797-6027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE SPINE INSTITUTE AT ORTHOPAEDIC ASSOCIATES PL",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-05",
        "last_updated": "2012-06-02",
        "status": "A",
        "authorized_official_last_name": "POELSTRA",
        "authorized_official_first_name": "KORNELIS",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "850-797-6027",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amie Terbrak, MOT, OTR/L
• Susan Wren Terry
• Barry Thomas Teusch
• Jason W Thackeray, M.D.
• Lam Thai
• The Village ABA, LLC
• Theodore I Macey MD PA
• Therapy Tree to Life LLC
• Vanessa Cloutier Thibodeaux, MD
• Thomas C. Church M.D., PA

• Orthopaedic Surgery Physician in Fort Walton Beach, FL
• Providers in Fort Walton Beach, FL by specialty
• Orthopaedic Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2012; 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.