Southeast Spine & Wellness Center LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

0104556637 Issued in VA

Legal business name

SOUTHEAST SPINE & WELLNESS CENTER LLC

Practice address

355 Crawford St
Suite 105
Portsmouth, VA 23704-2816

Phone

(757) 399-4700

Fax

(757) 399-0011

NPI assigned

Apr 1, 2009

Last updated

Jul 8, 2014By 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

Stephen Michael Genthner, D.C.NPI 1407030653

Title

Owner/Doctor of Chiropractic

Phone

(757) 399-4700

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Locations

Interoperability endpoints

• Direct secure messaging: drashley@otfc0001.direct.chirotouch.md

Practitioners 4

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.

• Stephen Michael Genthner, D.C.

  • Chiropractor
  • Portsmouth, VA
  • NPI 1407030653
  Medicare reassignment Care Compare group Authorized official
• Ashley Parmarter Genthner, D.C.

  • Chiropractor
  • Portsmouth, VA
  • NPI 1982839718
  Medicare reassignment Care Compare group
• Erika Nicole Lackey

  • Chiropractor
  • Portsmouth, VA
  • NPI 1295241396
  Medicare reassignment NPD
• David E Ranzette, DC

  • Chiropractor
  • Virginia Beach, VA
  • NPI 1467489690
  NPD (past)

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

{
    "created_epoch": "1238544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404777600000",
    "number": "1467694729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 CRAWFORD ST",
            "address_2": "SUITE 105",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237042816",
            "telephone_number": "757-399-4700",
            "fax_number": "757-399-0011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 CRAWFORD ST",
            "address_2": "SUITE 105",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237042816",
            "telephone_number": "757-399-4700",
            "fax_number": "757-399-0011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST SPINE & WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-01",
        "last_updated": "2014-07-08",
        "status": "A",
        "authorized_official_last_name": "GENTHNER",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER/DOCTOR OF CHIROPRACTIC",
        "authorized_official_telephone_number": "757-399-4700",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104556637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Franklin M Soriano Jr., M.D.
• Dana Marie Sorrells
• Tiana Sotepenra, PA
• Alain Soto Lopez, MD
• Stephanie Sottile, BS, RN, CMSRN
• Southern Surgical Associates LLC (Commonwealth Surgical Associates)
• Southside Group Homes, LLC (Southside Group Homes)
• Gautam Sowda, DPM
• Hannah Spanik, LPC
• Andrew Paul Spencer, RN

• Chiropractor in Portsmouth, VA
• Providers in Portsmouth, VA by specialty
• Chiropractor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2014; 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.