Spine Specialist of Michigan PC

Primary specialty

Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X

Legal business name

SPINE SPECIALIST OF MICHIGAN PC

Practice address

32270 Telegraph Rd
Bingham Farms, MI 48025-2456

Phone

(248) 792-9496

Fax

(248) 792-9628

NPI assigned

Jun 21, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Louis N Radden, DONPI 1184675886

Title

President

Phone

(248) 497-9477

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Spine Specialists of Michigan PC

  • Orthopaedic Surgery of the Spine Physician
  • Bingham Farms, MI
  • NPI 1891822565

  O20070402000538

  Same enrollment

Locations

Practitioners 7

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

• Louis Nathaniel Radden, DO

  • Orthopaedic Surgery Physician
  • Bingham Farms, MI
  • NPI 1184675886
  NPD Authorized official
• Jennifer Gamble, NP-C

  • Adult Health Nurse Practitioner
  • West Bloomfield, MI
  • NPI 1932599073
  NPD
• Gary G Gilyard, MD

  • Orthopaedic Surgery Physician
  • Warren, MI
  • NPI 1710967815
  NPD
• Jacqueline Hardy

  • Physician Assistant
  • Bingham Farms, MI
  • NPI 1356981906
  NPD
• Dima Sprague

  • Surgical Physician Assistant
  • Warren, MI
  • NPI 1275872376
  NPD
• Jason Adam Bitkowski, D.O.

  • Surgery Physician
  • Jonesboro, GA
  • NPI 1356555718
  NPD
• Lilia Marina Mleczko, NP-C

  • Nurse Practitioner
  • Bingham Farms, MI
  • NPI 1538535562
  NPD (past)

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

{
    "created_epoch": "1182384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679961600000",
    "number": "1760687487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32406 FRANKLIN RD UNIT 250493",
            "city": "FRANKLIN",
            "state": "MI",
            "postal_code": "480257016",
            "telephone_number": "248-497-9477",
            "fax_number": "248-865-4231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32270 TELEGRAPH RD",
            "city": "BINGHAM FARMS",
            "state": "MI",
            "postal_code": "480252456",
            "telephone_number": "248-792-9496",
            "fax_number": "248-792-9628"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6621 W Maple Rd",
            "address_purpose": "LOCATION",
            "city": "West Bloomfield",
            "state": "MI",
            "postal_code": "483224928",
            "country_code": "US",
            "telephone_number": "248-661-4700",
            "fax_number": "248-661-6210",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SPINE SPECIALIST OF MICHIGAN PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-21",
        "last_updated": "2023-03-28",
        "certification_date": "2023-03-28",
        "status": "A",
        "authorized_official_last_name": "RADDEN",
        "authorized_official_first_name": "LOUIS",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-497-9477",
        "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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "DF7468",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Spartan Diagnostics LLC
• Sarah Rose Speaks, M.ED., BCBA, LBA
• Brittany Renee Spear
• Latena Antionette Speeks
• Clarissa Vera Spencer
• Spine Specialists of Michigan PC
• Katelyn Danielle Spitzley
• Chelsea Sporn
• Marissa Spraggins
• Morgan Sroka, DPT

• Orthopaedic Surgery of the Spine Physician in Bingham Farms, MI
• Providers in Bingham Farms, MI by specialty
• Orthopaedic Surgery of the Spine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2023; 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.