Holdings of Spinecare, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

008169 Issued in TX

Legal business name

HOLDINGS OF SPINECARE, LLC

Practice address

5734 Spohn Drive
Suite B
Corpus Christi, TX 78414-4116

Phone

(361) 724-3292

Fax

(361) 371-7268

NPI assigned

Jan 4, 2007

Organization subpart

Yes

Parent organization

HOLDINGS OF SPINECARE, LLCAs reported in NPPES

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

Authorized official

Name

Jordon Fowler

Title

Ceo

Phone

(917) 216-6285

Specialties & licenses 1

Addresses

Other names 1

• Spinecare LLP Former legal business name

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Listed as

Spinecare LLPCCN 45C0001429

Medicare certification status

ActiveFrom the Provider of Services file

Part of

Holdings of Spinecare LLC

Locations

Practitioners 1

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

• Ryan Nelson Potter, M.D.

  • Specialist
  • Corpus Christi, TX
  • NPI 1730107095
  NPD

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656460800000",
    "number": "1578610564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5734 SPOHN DRIVE",
            "address_2": "SUITE B",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784144116",
            "telephone_number": "361-724-3292",
            "fax_number": "361-371-7268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5734 SPOHN DRIVE",
            "address_2": "SUITE B",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784144116",
            "telephone_number": "361-724-3292",
            "fax_number": "361-371-7268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLDINGS OF SPINECARE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HOLDINGS OF SPINECARE, LLC",
        "enumeration_date": "2007-01-04",
        "last_updated": "2022-06-29",
        "certification_date": "2022-06-29",
        "status": "A",
        "authorized_official_last_name": "FOWLER",
        "authorized_official_first_name": "JORDON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "917-216-6285"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "TX",
            "license": "008169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Spinecare LLP",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Carla Hoffman, BC-HIS
• Jon W Hoffman
• Katherine Elizabeth Hoffman, DO
• Laurie Jane Hoffman
• Steven V Hoffman
• Chad R. Hollenbaugh, LPC
• Andrea Louise Holley, FNP
• Cody Lee Holliman, CRNA
• Merissa Ann Hollingsworth, D.C.
• Thomas Raymond Hollingsworth III, DC

• Ambulatory Surgical Clinic/Center in Corpus Christi, TX
• Providers in Corpus Christi, TX by specialty
• Ambulatory Surgical Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.