Advanced Spine & Joint

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

3142P Issued in KY

Legal business name

ADVANCED SPINE & JOINT

Practice address

2404 New Holt Rd
Paducah, KY 42001

Phone

(270) 534-4803

Fax

(270) 534-4024

NPI assigned

May 11, 2009

Last updated

Jul 21, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Tracie Lynn Bullock, ARNPNPI 1891878641

Title

Arnp

Phone

(270) 534-4803

Specialties & licenses 1

Addresses

Locations

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Tracie L. Bullock, A.P.R.N.

  • Nurse Practitioner
  • Knoxville, TN
  • NPI 1891878641
  NPD (past) Authorized official
• Samuel Kent Clark, D.C.

  • Chiropractor
  • Paducah, KY
  • NPI 1811903800
  NPD (past)
• Gary A Smith, ARNP

  • Nurse Practitioner
  • Murry, KY
  • NPI 1225028897

  Family

  NPD (past)
• Verlinda Henshaw, OTD

  • Occupational Therapist
  • Marion, IL
  • NPI 1316011687
  NPD (past)
• Paul Brian Juergens, M.D.

  • Pain Medicine Physician
  • Du Quoin, IL
  • NPI 1922026673
  NPD (past)
• Daniel Lee Porter, OTR

  • Occupational Therapist
  • Marion, IL
  • NPI 1679861710
  NPD (past)

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

{
    "created_epoch": "1242000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279670400000",
    "number": "1447484118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2404 NEW HOLT RD",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "42001",
            "telephone_number": "270-534-4803",
            "fax_number": "270-534-4024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2404 NEW HOLT RD",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "42001",
            "telephone_number": "270-534-4803",
            "fax_number": "270-534-4024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED SPINE & JOINT",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-11",
        "last_updated": "2010-07-21",
        "status": "A",
        "authorized_official_last_name": "BULLOCK",
        "authorized_official_first_name": "TRACIE",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "ARNP",
        "authorized_official_telephone_number": "270-534-4803",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "ARNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3142P",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adio Pharmacy Distribution Services (Four Rivers Pharmacy)
• Gregory M Adler, PT
• Adonai Integrative Medicine PLLC
• Advanced Behavioral Wellness LLC
• Advanced Internal Medicine PLLC
• Advancing Medical Solutions PSC
• Affiliates in Pathology SC
• Affordable Dentures & Implants - Kentucky, PLLC
• Jean Ahern, O.T.
• Air Evac EMS, Inc. (Air Evac Lifeteam)

• Family Nurse Practitioner in Paducah, KY
• Providers in Paducah, KY by specialty
• Family Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2010; 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.