MD Spine and Health Center LLC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

Legal business name

MD SPINE AND HEALTH CENTER LLC

Doing business as

MDSH

Practice address

27789 Mound Rd Ste 100
Warren, MI 48092-2697

Phone

(313) 209-3353

NPI assigned

Nov 17, 2017

Last updated

Apr 30, 2021By 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

Sam Hackette, MD

Title

Owner

Phone

(727) 422-4688

Specialties & licenses 1

Addresses

Other names 1

• MDSH Doing business as

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

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 1

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.

• Sam Hakki Hackette, MD

  • Adult Reconstructive Orthopaedic Surgery Physician
  • Warren, MI
  • NPI 1043253602
  Medicare reassignment NPD

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

{
    "created_epoch": "1510876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619740800000",
    "number": "1659885200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 880",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483110880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27789 MOUND RD STE 100",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480922697",
            "telephone_number": "313-209-3353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MD SPINE AND HEALTH CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-17",
        "last_updated": "2021-04-30",
        "certification_date": "2021-04-30",
        "status": "A",
        "authorized_official_last_name": "HACKETTE",
        "authorized_official_first_name": "SAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "727-422-4688",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MDSH",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rebecca Lyn McLeod, ATC
• Michele Dawn McMahon, ACNP-BC
• Rita H McNally, NP
• McNichols Xray Clinic PC
• Ann Marie McPherson
• MD Urgent Care & Family Practice PLLC (24 Hour Urgent Care Centers)
• MD Urgent Care and Family Medicine PLLC (24 HR Lifeline Urgent Care & Family Medicine)
• Claire Elizabeth Mears, DO
• Julio Mece, PHARMD
• Med Care Home Health Care, Inc

• Medical Specialty Clinic/Center in Warren, MI
• Providers in Warren, MI by specialty
• Medical Specialty Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2021; 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.