Integrated Sports and Spine, LLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

ME97457 Issued in FL

Legal business name

INTEGRATED SPORTS AND SPINE, LLC

Practice address

2905 Rigsby LN
Safety Harbor, FL 34695-4828

Phone

(727) 797-0500

Fax

(727) 797-0050

NPI assigned

Mar 14, 2008

Last updated

Mar 14, 2008By 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

Dr. Damon Stafford, DC

Title

Owner

Phone

(727) 797-0500

Specialties & licenses 2

Addresses

Other identifiers 1

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

{
    "created_epoch": "1205452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205452800000",
    "number": "1629249909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2905 RIGSBY LN",
            "city": "SAFETY HARBOR",
            "state": "FL",
            "postal_code": "346954828",
            "telephone_number": "727-797-0500",
            "fax_number": "727-797-0050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2905 RIGSBY LN",
            "city": "SAFETY HARBOR",
            "state": "FL",
            "postal_code": "346954828",
            "telephone_number": "727-797-0500",
            "fax_number": "727-797-0050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED SPORTS AND SPINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-14",
        "last_updated": "2008-03-14",
        "status": "A",
        "authorized_official_last_name": "STAFFORD",
        "authorized_official_first_name": "DAMON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "727-797-0500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH8146",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME97457",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "CH8146",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Safety Harbor, FL
• Providers in Safety Harbor, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2008; 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.