Spine Institute on the Emerald Coast

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

Legal business name

SPINE INSTITUTE ON THE EMERALD COAST

Doing business as

The Spine and Pain Institute

Practice address

12276 San Jose Blvd Ste 210
Jacksonville, FL 32223-8631

Phone

(904) 717-9625

Fax

(904) 683-6499

NPI assigned

Aug 17, 2021

Organization subpart

No

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

Authorized official

Name

Amrish Patel, MDNPI 1871755025

Title

Chief Medical Officer; Owner

Phone

(850) 460-2350

Specialties & licenses 2

Addresses

Other names 1

• THE SPINE AND PAIN INSTITUTE Doing business as

Electronic endpoints 1

Locations

Practitioners 2

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

• Amrish Patel, MD

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • McDonough, GA
  • NPI 1871755025
  NPD (past) Authorized official
• Bradley Hamilton Young, DC

  • Chiropractor
  • Shalimar, FL
  • NPI 1366538035
  NPD (past)

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

{
    "created_epoch": "1629158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712707200000",
    "number": "1780350298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 600366",
            "city": "ST JOHNS",
            "state": "FL",
            "postal_code": "322600366",
            "telephone_number": "904-717-9625",
            "fax_number": "904-683-6499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12276 SAN JOSE BLVD STE 210",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322238631",
            "telephone_number": "904-717-9625",
            "fax_number": "904-683-6499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPINE INSTITUTE ON THE EMERALD COAST",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-17",
        "last_updated": "2024-04-10",
        "certification_date": "2024-04-10",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "AMRISH",
        "authorized_official_title_or_position": "CHIEF MEDICAL OFFICER; OWNER",
        "authorized_official_telephone_number": "850-460-2350",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "spineandpain@si.azalea.phimailbox.com",
            "affiliation": "N",
            "address_1": "3101 University Blvd S Ste 200",
            "city": "Jacksonville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "322162753",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "THE SPINE AND PAIN INSTITUTE",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "THE SPINE AND PAIN INSTITUTE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Christie Spillman, DPT
• Maryalice Spin, MD
• Sarah Spina
• Spinal Solutions Jax Inc (Spinal Science)
• Kristen Marie Spinato, APRN
• Spine, Brain and Joint Institute
• Angela M Spinelli, D.O.
• Joseph Spinelli, M.D.
• Lisa Spink, DPT
• Ashley Ann Spinks, CSFA

• Interventional Pain Medicine Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Interventional Pain Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2024; 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.