Organization Active NPI

Spine & Nerve Diagnostic Center

  • Physical Medicine & Rehabilitation Physician
  • Davis, CA
National Provider Identifier
1467016303
Registry record updated Jun 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
SPINE & NERVE DIAGNOSTIC CENTER
Doing business as
Spine & Nerve Diagnostic Center
Practice address
635 Anderson Rd Ste 15
Davis, CA 95616-3505
Phone
(916) 772-5325
Fax
(916) 772-6333
NPI assigned
Apr 25, 2019
Organization subpart
Yes
Parent organization
SPINE & NERVE DIAGNOSTIC CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 11, 2019

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

Authorized official

Name
Vinay Moola Reddy
Title
President and Ceo
Phone
(916) 772-5325

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208100000X Primary

Addresses

Primary practice location

635 Anderson Rd Ste 15
Davis, CA 95616-3505

Mailing address

1528 Eureka Rd Ste 103
Roseville, CA 95661-3047
Phone (916) 772-5325

Other names 1

  • Spine & Nerve Diagnostic Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Spine Nerve Diagnostic Ctr3 organizations share this tax ID, including this one
Part of
Spine Nerve Diagnostic Ctr

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

635 Anderson Rd
Ste 15
Davis, CA 95616
Phone (530) 757-7062

NPI Registry JSON

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

{
    "created_epoch": "1556150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560211200000",
    "number": "1467016303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1528 EUREKA RD STE 103",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956613047",
            "telephone_number": "916-772-5325",
            "fax_number": "916-772-6333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 ANDERSON RD STE 15",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "956163505",
            "telephone_number": "916-772-5325",
            "fax_number": "916-772-6333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPINE & NERVE DIAGNOSTIC CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SPINE & NERVE DIAGNOSTIC CENTER",
        "enumeration_date": "2019-04-25",
        "last_updated": "2019-06-11",
        "status": "A",
        "authorized_official_last_name": "REDDY",
        "authorized_official_first_name": "VINAY",
        "authorized_official_middle_name": "MOOLA",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "916-772-5325"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Spine & Nerve Diagnostic Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Spine & Nerve Diagnostic Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Davis, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.