Advanced Spine & Therapy, LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

ADVANCED SPINE & THERAPY, LLC

Practice address

300 Crestwood Cir
Mena, AR 71953-5515

Phone

(479) 216-2315

Fax

(479) 413-8090

NPI assigned

Mar 29, 2023

Last updated

Nov 30, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Delta Gunn

Title

Practice Manager

Phone

(479) 216-2315

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Adam Gunn, PT, DPT, OCS

  • Physical Therapist
  • Mena, AR
  • NPI 1184133159
  Medicare reassignment Care Compare group NPD
• Joshua Daniel Sirkis, PT, DPT

  • Physical Therapist
  • Mena, AR
  • NPI 1174166623
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1680048000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732924800000",
    "number": "1750085189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 CRESTWOOD CIR",
            "city": "MENA",
            "state": "AR",
            "postal_code": "719535515",
            "telephone_number": "479-216-2315",
            "fax_number": "479-413-8090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 CRESTWOOD CIR",
            "city": "MENA",
            "state": "AR",
            "postal_code": "719535515",
            "telephone_number": "479-216-2315",
            "fax_number": "479-413-8090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED SPINE & THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-29",
        "last_updated": "2024-11-30",
        "certification_date": "2024-11-30",
        "status": "A",
        "authorized_official_last_name": "GUNN",
        "authorized_official_first_name": "DELTA",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "479-216-2315",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "319883742",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Access Medical Clinic Arkansas LLC
• Michael Stephen Adams, M.D.
• Advocate Medical Support Group
• John Scott Agee, CRNA
• Ak Medical Support Services
• Mary Kay Alexandar, OTR
• Alina Mielnick, MD, PA

• Physical Therapy Clinic/Center in Mena, AR
• Providers in Mena, AR by specialty
• Physical Therapy Clinic/Center in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2024; 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.