Spine & Musculoskeletal Center PC

Primary specialty

Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X

License

2001917 Issued in IN

Legal business name

SPINE & MUSCULOSKELETAL CENTER PC

Practice address

2020 E Columbus Drive
Suite B
East Chicago, IN 46312-3078

Phone

(219) 397-8648

Fax

(219) 397-8653

NPI assigned

Jul 6, 2007

Organization subpart

No

Name

Dr. Joseph P Spott, DONPI 1568437937

Title

Owner

Phone

(219) 397-8648

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

• Joseph Phillip Spott, D.O.

  • Orthopaedic Surgery Physician
  • East Chicago, IN
  • NPI 1568437937

  IN

  Medicare reassignment Authorized official
• Ariel Patricia Brazzale, FNP- BC

  • Nurse Practitioner
  • Saint John, IN
  • NPI 1568992055

  IN

  Medicare reassignment NPD

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

• Superior Orthopedics Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 15, 2013.

{
    "created_epoch": "1183680000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384473600000",
    "number": "1689872152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9430 WICKER AVE",
            "city": "SAINT JOHN",
            "state": "IN",
            "postal_code": "463739768",
            "telephone_number": "219-558-8068",
            "fax_number": "219-558-8149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 E COLUMBUS DRIVE",
            "address_2": "SUITE B",
            "city": "EAST CHICAGO",
            "state": "IN",
            "postal_code": "463123078",
            "telephone_number": "219-397-8648",
            "fax_number": "219-397-8653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPINE & MUSCULOSKELETAL CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-06",
        "last_updated": "2013-11-15",
        "status": "A",
        "authorized_official_last_name": "SPOTT",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "219-397-8648",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "IN",
            "license": "2001917",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200184170D",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7538064",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "P00222849",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036105846",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS IL",
            "identifier": "90001235",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000373304",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Superior Orthopedics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in East Chicago, IN
• Orthopaedic Surgery of the Spine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2013; 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.