Southern Orthopedic Spine Surgery, LLC

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

Legal business name

SOUTHERN ORTHOPEDIC SPINE SURGERY, LLC

Practice address

1399 Jenks Ave BLDG G
Panama City, FL 32401-2442

Phone

(850) 771-2001

Fax

(850) 215-4229

NPI assigned

Mar 28, 2018

Organization subpart

No

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

Authorized official

Name

Cory R. Gaiser, DONPI 1386689867

Title

Owner

Phone

(850) 771-2001

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL2 enrollments

Enrollment records 2

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/17921/brand/1/csg/1/fhir/r4

Practitioners 3

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

• Cory R Gaiser, D.O.

  • Orthopaedic Surgery Physician
  • Panama City, FL
  • NPI 1386689867
  Medicare reassignment Care Compare group NPD Authorized official
• Julia Hales, APRN, MSN, FNP-C

  • Nurse Practitioner
  • Panama City, FL
  • NPI 1376178632
  Medicare reassignment Care Compare group NPD
• Robert Nelson Mead, M.D.

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Panama City, FL
  • NPI 1700223278
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1522195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1541462400000",
    "number": "1689179053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1399 JENKS AVE BLDG G",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324012442",
            "telephone_number": "850-771-2001",
            "fax_number": "850-215-4229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1399 JENKS AVE BLDG G",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324012442",
            "telephone_number": "850-771-2001",
            "fax_number": "850-215-4229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN ORTHOPEDIC SPINE SURGERY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-28",
        "last_updated": "2018-11-06",
        "status": "A",
        "authorized_official_last_name": "GAISER",
        "authorized_official_first_name": "CORY",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "850-771-2001",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Southern Home Care Services, Inc.
• Southern Living Homecare LLC
• Southern Magnolia Healthcare
• Southern Orthopedic Specialists PA
• Southern Orthopedic Specialists PA
• Southern Perinatal RN Co LLC
• Southern Shores Family Wellness
• Southern Vascular of Panama City PLLC
• Ashley Nicole Sowell, ARNP
• Jada A Spease

• Orthopaedic Surgery Physician in Panama City, FL
• Providers in Panama City, FL by specialty
• Orthopaedic Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.