NPIMap

Spine Surgery, PSC

Organization Active NPI Orthopaedic Surgery of the Spine Physician · Louisville, KY

NPI 1447236237 · NPPES record last updated Apr 7, 2008

Key facts

NPI
1447236237
Entity type
Organization (NPI type 2)
Primary specialty
Orthopaedic Surgery of the Spine Physician 207XS0117X
Legal business name
SPINE SURGERY, PSC
Practice address
210 E Gray St
Suite 601
Louisville, KY 40202-3902
Phone
(502) 585-2300
Fax
(502) 584-2726
NPI assigned
Dec 22, 2005
Organization subpart
Yes
Parent organization (as reported)
SPINE SURGERY, PSC

Authorized official

Name
Mrs. Linette M Gadwah
Title
Credentialing Coordinator
Phone
(502) 585-2300

Practitioners 13

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

National Provider Directory

Part of
Spine Surgery PSC

Locations

590 Missouri Ave
Jeffersonville, IN 47130
Phone (812) 282-8400

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery of the Spine Physician
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP		 207XS0117X Yes

Addresses

Primary practice location

210 E Gray St
Suite 601
Louisville, KY 40202-3902

Mailing address

210 E Gray St
Suite 601
Louisville, KY 40202-3902
Phone (502) 585-2300

Other identifiers

IdentifierTypeStateIssuer
65918583MedicaidKY

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Apr 7, 2008.

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207526400000",
    "number": "1447236237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 E GRAY ST",
            "address_2": "SUITE 601",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402023902",
            "telephone_number": "502-585-2300",
            "fax_number": "502-584-2726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 E GRAY ST",
            "address_2": "SUITE 601",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402023902",
            "telephone_number": "502-585-2300",
            "fax_number": "502-584-2726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPINE SURGERY, PSC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SPINE SURGERY, PSC",
        "enumeration_date": "2005-12-22",
        "last_updated": "2008-04-07",
        "status": "A",
        "authorized_official_last_name": "GADWAH",
        "authorized_official_first_name": "LINETTE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "502-585-2300",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65918583",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

All providers in Louisville, KY · Orthopaedic Surgery of the Spine Physician in Kentucky

Sources for this page

Verify at the official NPI Registry.