Spinal Therapeutics Corp.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

5101006701 Issued in MI

Legal business name

SPINAL THERAPEUTICS CORP.

Practice address

22731 Newman St
Suite 102
Dearborn, MI 48124-2034

Phone

(313) 792-8742

NPI assigned

Nov 1, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Earl E. McHugh, CLU, CHFC

Title

President

Phone

(248) 229-7878

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1699853523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2084",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481232084",
            "telephone_number": "313-792-8472",
            "fax_number": "313-792-2782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22731 NEWMAN ST",
            "address_2": "SUITE 102",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481242034",
            "telephone_number": "313-792-8742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPINAL THERAPEUTICS CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MCHUGH",
        "authorized_official_first_name": "EARL",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-229-7878",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CLU, CHFC"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101006701",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "16660009",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR. BARDEN STATE LICENSE",
            "identifier": "5101006701",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Specialty Medical Center Inc
• Tamara Yvette Spence, NURSE PRACTITIONER
• Claudia Spencer
• Rodney E Spencer, MA, LLP, LMSW
• Jeffrey Wallace Spier, M.A., L.L.P., CEAP
• Spinal Therapeutics, Inc
• Spine Rehab PLLC
• Spinemd of Michigan, PLLC
• Janice Springer, NNP
• Vaishnavi Srivatsan, PT

• Family Medicine Physician in Dearborn, MI
• Providers in Dearborn, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.