Tampa Interventional Spine Physicians LLC

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

License

105149 Issued in FL

Legal business name

TAMPA INTERVENTIONAL SPINE PHYSICIANS LLC

Practice address

1000 W Kennedy Blvd
Suite 201
Tampa, FL 33606-1940

Phone

(813) 258-2225

Fax

(813) 258-8118

NPI assigned

Dec 6, 2012

Organization subpart

No

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

Authorized official

Name

Kortni Flynn

Title

Owner

Phone

(989) 714-1839

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1354752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354838400000",
    "number": "1508101296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 W KENNEDY BLVD",
            "address_2": "SUITE 201",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336061940",
            "telephone_number": "813-258-2225",
            "fax_number": "813-258-8118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 W KENNEDY BLVD",
            "address_2": "SUITE 201",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336061940",
            "telephone_number": "813-258-2225",
            "fax_number": "813-258-8118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAMPA INTERVENTIONAL SPINE PHYSICIANS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-06",
        "last_updated": "2012-12-07",
        "status": "A",
        "authorized_official_last_name": "FLYNN",
        "authorized_official_first_name": "KORTNI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "989-714-1839"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "FL",
            "license": "98264",
            "primary": false
        },
        {
            "code": "207RA0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "FL",
            "license": "105149",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "FL",
            "license": "105149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Interventional Pain Medicine Physician in Tampa, FL
• Providers in Tampa, FL by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2012; 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.