Spine West a Professional LLC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

Legal business name

SPINE WEST A PROFESSIONAL LLC

Practice address

3555 Lutheran Pkwy Ste 210
Wheat Ridge, CO 80033-6037

Phone

(303) 494-7773

Fax

(303) 494-1104

NPI assigned

Sep 1, 2020

Organization subpart

Yes

Parent organization

SPINE WEST A PROFESSIONAL LLCAs reported in NPPES

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

Authorized official

Name

David Rodriguez

Title

Practice Manager

Phone

(303) 494-7773

Specialties & licenses 1

Addresses

Part of

Spine West a Professional LLC

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Spine West a Professional LLC

  • Physical Medicine & Rehabilitation Physician
  • Boulder, CO
  • NPI 1427091206
  NPPES parent name

Practitioners 2

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

• John Tobey, MD

  • Physical Medicine & Rehabilitation Physician
  • Boulder, CO
  • NPI 1013902352
  NPD
• Jason Andrade

  • Physical Medicine & Rehabilitation Physician
  • Roseville, CA
  • NPI 1245727304
  NPD

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

{
    "created_epoch": "1598918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598918400000",
    "number": "1780298307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5387 MANHATTAN CIR STE 200",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803034283",
            "telephone_number": "303-494-7773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3555 LUTHERAN PKWY STE 210",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800336037",
            "telephone_number": "303-494-7773",
            "fax_number": "303-494-1104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPINE WEST A PROFESSIONAL LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SPINE WEST A PROFESSIONAL LLC",
        "enumeration_date": "2020-09-01",
        "last_updated": "2020-09-01",
        "certification_date": "2020-09-01",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "303-494-7773"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shelly C Spencer
• Laurie Sperry, PHD, BCBA-D, MSC
• Michael Hunter Spicer, PTA
• Joseph Spidell, LMT
• Kendall Spina, LMSW
• Kathryn A Spott, NP
• Deanie J Spurlock-Gebhard
• Megann Jeanne St John, M.A.
• Melissa St. Clair, LPC
• Michael John Stackpool, M.D.

• Physical Medicine & Rehabilitation Physician in Wheat Ridge, CO
• Providers in Wheat Ridge, CO by specialty
• Physical Medicine & Rehabilitation Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 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.