Spinecare Medical Group

Primary specialty

SpecialistTaxonomy code 174400000X

License

09377R Issued in LA

Legal business name

SPINECARE MEDICAL GROUP

Practice address

151 Ochsner Blvd Ste H
Gretna, LA 70056-5256

Phone

(504) 392-7123

Fax

(504) 392-7823

NPI assigned

Oct 10, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Alexis M Waguespack, MDNPI 1457388035

Title

MD

Phone

(504) 392-7123

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in LA2 enrollments

Enrollment records 2

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/8550/brand/1/csg/1/fhir/r4

Practitioners 2

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

• Alexis M Waguespack, M.D.

  • Orthopaedic Surgery of the Spine Physician
  • Gretna, LA
  • NPI 1457388035
  Medicare reassignment NPD Authorized official
• Randall Mark Wilk, MD DDS PHD

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Gretna, LA
  • NPI 1669578944
  NPD (past)

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785196800000",
    "number": "1467540179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 OCHSNER BLVD STE H",
            "city": "GRETNA",
            "state": "LA",
            "postal_code": "700565256",
            "telephone_number": "504-392-7123",
            "fax_number": "504-392-7823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 OCHSNER BLVD STE H",
            "city": "GRETNA",
            "state": "LA",
            "postal_code": "700565256",
            "telephone_number": "504-392-7123",
            "fax_number": "504-392-7823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPINECARE MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-10",
        "last_updated": "2026-07-28",
        "certification_date": "2026-07-28",
        "status": "A",
        "authorized_official_last_name": "WAGUESPACK",
        "authorized_official_first_name": "ALEXIS",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "504-392-7123",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "LA",
            "license": "09377R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1955884",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3376644",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Gretna, LA
• Providers in Gretna, LA by specialty
• Specialist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.