NPIMap

Organization Active NPI

Center for Minimally Invasive Spinecare, Inc

  • Orthopaedic Surgery of the Spine Physician
  • Mishawaka, IN
National Provider Identifier
1447798939
Registry record updated Feb 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X
License
01065998A Issued in IN
Legal business name
CENTER FOR MINIMALLY INVASIVE SPINECARE, INC
Practice address
270 E Day Rd
Suite #200
Mishawaka, IN 46545-3444
Phone
(574) 850-8408
NPI assigned
Feb 6, 2017
Last updated
Feb 6, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2017

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

Authorized official

Name
Dr. Thomas James Mango, M.D.
Title
Owner
Phone
(574) 850-8408

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery of the Spine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207XS0117X 01065998A IN Primary

Addresses

Primary practice location

270 E Day Rd
Suite #200
Mishawaka, IN 46545-3444

Mailing address

50960 Fox TRL
Granger, IN 46530-9039
Phone (574) 850-8408

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1486339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486339200000",
    "number": "1447798939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50960 FOX TRL",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465309039",
            "telephone_number": "574-850-8408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270 E DAY RD",
            "address_2": "SUITE #200",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465453444",
            "telephone_number": "574-850-8408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR MINIMALLY INVASIVE SPINECARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-06",
        "last_updated": "2017-02-06",
        "status": "A",
        "authorized_official_last_name": "MANGO",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "574-850-8408",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "IN",
            "license": "01065998A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mishawaka, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2017; 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.