NPIMap

Organization Active NPI

Premier Spine Specialists, LLC

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Port St Lucie, FL
National Provider Identifier
1669756227
Registry record updated Sep 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
License
ME105483 Issued in FL
Legal business name
PREMIER SPINE SPECIALISTS, LLC
Practice address
10801 SW Tradition SQ
Port St Lucie, FL 34987-1934
Phone
(772) 345-3933
Fax
(772) 345-3937
NPI assigned
Sep 30, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2011

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

Authorized official

Name
Dr. William J Jensen, DC
Title
Owner
Phone
(772) 345-3933

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2081P2900X ME105483 FL Primary

Addresses

Primary practice location

10801 SW Tradition SQ
Port St Lucie, FL 34987-1934

Mailing address

10801 SW Tradition SQ
Port St Lucie, FL 34987-1934
Phone (772) 345-3933

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1317340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317340800000",
    "number": "1669756227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10801 SW TRADITION SQ",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349871934",
            "telephone_number": "772-345-3933",
            "fax_number": "772-345-3937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10801 SW TRADITION SQ",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349871934",
            "telephone_number": "772-345-3933",
            "fax_number": "772-345-3937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER SPINE SPECIALISTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-30",
        "last_updated": "2011-09-30",
        "status": "A",
        "authorized_official_last_name": "JENSEN",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "772-345-3933",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "FL",
            "license": "ME105483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2011; 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.