Spine Medical Center,LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

12692 Issued in MS

Legal business name

SPINE MEDICAL CENTER,LLC

Practice address

9344 Three Rivers Rd
Gulfport, MS 39503-4268

Phone

(228) 865-4731

Fax

(228) 863-5616

NPI assigned

Apr 25, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Joel Berman Burwell, D.O.

Title

Dr.

Phone

(228) 865-4731

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1720207749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2156",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395052156",
            "telephone_number": "228-865-4731",
            "fax_number": "228-863-5616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9344 THREE RIVERS RD",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395034268",
            "telephone_number": "228-865-4731",
            "fax_number": "228-863-5616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPINE MEDICAL CENTER,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BURWELL",
        "authorized_official_first_name": "JOEL",
        "authorized_official_middle_name": "BERMAN",
        "authorized_official_title_or_position": "DR.",
        "authorized_official_telephone_number": "228-865-4731",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "12692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Spine Institute of Mississippi
• Spine Med - Center
• Marcella Darice Spinnato, R.N.
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• Angela Marie Spring, MSW
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• Family Medicine Physician in Gulfport, MS
• Providers in Gulfport, MS by specialty
• Family Medicine Physician in Mississippi

• 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.