NPIMap

Organization Active NPI

Spinal Integrated Medicine, LLC

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Punta Gorda, FL
National Provider Identifier
1689079709
Registry record updated Oct 31, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X
Legal business name
SPINAL INTEGRATED MEDICINE, LLC
Practice address
324 Cross St
Punta Gorda, FL 33950-4828
Phone
(941) 205-2180
Fax
(941) 205-2181
NPI assigned
Oct 31, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2014

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

Authorized official

Name
Kevin M. Van Nostrand, B.S., D.C,
Title
President
Phone
(941) 205-2180

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Physical Medicine & Rehabilitation) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2081S0010X Primary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X

Addresses

Primary practice location

324 Cross St
Punta Gorda, FL 33950-4828

Mailing address

324 Cross St
Punta Gorda, FL 33950-4828
Phone (941) 205-2180

National Provider Directory

National Provider Directory

Locations

324 Cross St
Punta Gorda, FL 33950
Phone (941) 205-2180

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1414713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414713600000",
    "number": "1689079709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324 CROSS ST",
            "city": "PUNTA GORDA",
            "state": "FL",
            "postal_code": "339504828",
            "telephone_number": "941-205-2180",
            "fax_number": "941-205-2181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 CROSS ST",
            "city": "PUNTA GORDA",
            "state": "FL",
            "postal_code": "339504828",
            "telephone_number": "941-205-2180",
            "fax_number": "941-205-2181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPINAL INTEGRATED MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-31",
        "last_updated": "2014-10-31",
        "status": "A",
        "authorized_official_last_name": "VAN NOSTRAND",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "941-205-2180",
        "authorized_official_credential": "B.S., D.C,"
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Punta Gorda, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2014; 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.