Organization Active NPI

Spine Cin of Milwaukee LLC

  • Orthopaedic Surgery Physician
  • Milwaukee, WI
National Provider Identifier
1477051753
Registry record updated May 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
SPINE CIN OF MILWAUKEE LLC
Practice address
310 E Buffalo St Ste 206
Milwaukee, WI 53202-5808
Phone
(615) 386-0064
Fax
(615) 386-0067
NPI assigned
Jan 31, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 8, 2021

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

Authorized official

Name
Edward Leland Hutton Eadie
Title
Director
Phone
(615) 733-2064

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X WI Primary
Orthopaedic Surgery of the Spine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207XS0117X WI

Addresses

Primary practice location

310 E Buffalo St Ste 206
Milwaukee, WI 53202-5808

Mailing address

102 Woodmont Blvd Ste 350
Nashville, TN 37205-2216
Phone (615) 386-0064

National Provider Directory

National Provider Directory

Locations

310 E Buffalo St
Ste 206
Milwaukee, WI 53202

NPI Registry JSON

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

{
    "created_epoch": "1517356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620432000000",
    "number": "1477051753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 WOODMONT BLVD STE 350",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372052216",
            "telephone_number": "615-386-0064",
            "fax_number": "615-386-0067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 E BUFFALO ST STE 206",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532025808",
            "telephone_number": "615-386-0064",
            "fax_number": "615-386-0067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPINE CIN OF MILWAUKEE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-31",
        "last_updated": "2021-05-08",
        "certification_date": "2021-05-08",
        "status": "A",
        "authorized_official_last_name": "EADIE",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "LELAND HUTTON",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "615-733-2064"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "WI",
            "license": null,
            "primary": true
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "WI",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2021; 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.