Advanced Sports & Spine, PLLC

Primary specialty

Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X

License

2015-01401 Issued in NC

Legal business name

ADVANCED SPORTS & SPINE, PLLC

Practice address

8035 Providence Rd
#340
Charlotte, NC 28277-9716

Phone

(704) 542-3988

NPI assigned

Apr 15, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Usman Fayyaz Ahmad, D.O.NPI 1558676692

Title

Sole Member

Phone

(704) 542-3988

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC, SC3 enrollments

Enrollment records 3

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 11

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

• Usman Ahmad, D.O.

  • Physical Medicine & Rehabilitation Physician
  • Charlotte, NC
  • NPI 1558676692

  NC, Pain Medicine, SC

  Medicare reassignment Care Compare group NPD Authorized official
• David Anthony Ciaccia, DO

  • Physical Medicine & Rehabilitation Physician
  • Charlotte, NC
  • NPI 1316380207

  NC

  Medicare reassignment Care Compare group NPD
• Lowell Harley Gill, M.D.

  • Orthopaedic Surgery Physician
  • Kinston, NC
  • NPI 1265533095
  NPD (past)
• Shelby Jane Ladd, PA-C

  • Physician Assistant
  • Charlotte, NC
  • NPI 1457138976
  NPD (past)
• Dhavel Chauhan, DPM

  • Foot & Ankle Surgery Podiatrist
  • Fort Mill, SC
  • NPI 1326626144
  NPD (past)
• Glen Thomas Feltham, MD

  • Orthopaedic Surgery Physician
  • Fort Mill, SC
  • NPI 1194716381
  NPD (past)
• Andrea L Gale, MD

  • Orthopaedic Hand Surgery Physician
  • West Columbia, SC
  • NPI 1306132261
  NPD (past)
• Jennifer Levash, PHYSICIAN ASSISTANT

  • Physician Assistant
  • Malvern, PA
  • NPI 1043594492
  NPD (past)
• Mallorie Llanas, MS, LAT, ATC, CES

  • Athletic Trainer
  • Fort Mill, SC
  • NPI 1487062550
  NPD (past)
• Christopher David Sutton, M.D.

  • Orthopaedic Surgery Physician
  • Fort Mill, SC
  • NPI 1366857849
  NPD (past)
• Brian David Tallerico, DO

  • Orthopaedic Surgery Physician
  • Fort Mill, SC
  • NPI 1538137724
  NPD (past)

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

{
    "created_epoch": "1460678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1523491200000",
    "number": "1629422738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8035 PROVIDENCE RD STE 340",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282779717",
            "telephone_number": "704-542-3988",
            "fax_number": "704-542-3912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8035 PROVIDENCE RD",
            "address_2": "#340",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282779716",
            "telephone_number": "704-542-3988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED SPORTS & SPINE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-15",
        "last_updated": "2018-04-12",
        "status": "A",
        "authorized_official_last_name": "AHMAD",
        "authorized_official_first_name": "USMAN",
        "authorized_official_middle_name": "FAYYAZ",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "704-542-3988",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "NC",
            "license": "2015-01401",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1629422738",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Advanced Physical Medicine
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• Advanced Reproductive Concepts, PLLC
• Advanced Therapy Services, LLC
• Advantage Vision Center
• Advantran Wheelchair Transportation LLC
• Advene Health Group, PLLC
• Advent Health Solutions, PLLC

• All providers in Charlotte, NC
• Pain Medicine (Physical Medicine & Rehabilitation) Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2018; 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.