Spine Capital LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

SPINE CAPITAL LLC

Practice address

1757 E Baseline Rd Ste 131
Gilbert, AZ 85233-1534

Phone

(480) 999-5248

Fax

(480) 999-5285

NPI assigned

Jan 4, 2024

Last updated

Apr 26, 2024By 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

Robert Mawunyo KoffieNPI 1760744460

Title

Chairman and Ceo

Phone

(480) 999-5248

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Spine Capital, LLC

  • Neurological Surgery Physician
  • Gilbert, AZ
  • NPI 1295447779

  6608240411

  Same PAC ID

Tax ID family

Spine Capital LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Spine Capital, LLC

  • Neurological Surgery Physician
  • Gilbert, AZ
  • NPI 1295447779
  NPD tax ID

Locations

Practitioners 2

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.

• Robert Mawunyo Koffie, MD

  • Neurological Surgery Physician
  • Gilbert, AZ
  • NPI 1760744460
  NPD Authorized official
• Hillary Ann Bashaw, APNP FNP-BC

  • Nurse Practitioner
  • Appleton, WI
  • NPI 1265048805
  NPD

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

{
    "created_epoch": "1704326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714089600000",
    "number": "1619747284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1757 E BASELINE RD STE 131",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852331534",
            "telephone_number": "480-999-5248",
            "fax_number": "480-999-5285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1757 E BASELINE RD STE 131",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852331534",
            "telephone_number": "480-999-5248",
            "fax_number": "480-999-5285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPINE CAPITAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-04",
        "last_updated": "2024-04-26",
        "certification_date": "2024-04-26",
        "status": "A",
        "authorized_official_last_name": "KOFFIE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "MAWUNYO",
        "authorized_official_title_or_position": "CHAIRMAN AND CEO",
        "authorized_official_telephone_number": "480-999-5248"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Kathleen Spender, M.S., CCC-SLP
• Sper,LLC
• Spero Psychiatry & Counseling (Spero Psychiatry and Counseling)
• Matthew Eric Spigel, D.O.
• Austin C Spiker, PTA
• Spine Capital, LLC
• Spooner Physical Therapy & Hand Rehab, PC (Spooner Gilbert)
• Jean Marie Spoor, COTA/L
• Sports & Orthopaedic Specialists of Arizona LLC
• Sportsdocs Family Chiropractic Group, Inc

• Durable Medical Equipment & Medical Supplies in Gilbert, AZ
• Providers in Gilbert, AZ by specialty
• Durable Medical Equipment & Medical Supplies in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2024; 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.