Organization Active NPI

Center for Spine and Sports Medicine LLC

  • Pain Medicine (Anesthesiology) Physician
  • Evansville, IN
National Provider Identifier
1801918024
Registry record updated Jan 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
01068416A Issued in IN
Legal business name
CENTER FOR SPINE AND SPORTS MEDICINE LLC
Practice address
7145 E Virginia St
Evansville, IN 47715-9144
Phone
(812) 476-7111
Fax
(812) 476-7117
NPI assigned
Apr 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2015

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

Authorized official

Name
Lisa Kay Hastetter
Title
Practice Manager
Phone
(812) 476-7111

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207LP2900X 01068416A IN Primary
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2081P2900X 01040195A IN

Addresses

Primary practice location

7145 E Virginia St
Evansville, IN 47715-9144

Mailing address

7145 E Virginia St
Suite 5000
Evansville, IN 47715-9144
Phone (812) 476-7111

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421107200000",
    "number": "1801918024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7145 E VIRGINIA ST",
            "address_2": "SUITE 5000",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477159144",
            "telephone_number": "812-476-7111",
            "fax_number": "812-476-7117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7145 E VIRGINIA ST",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477159144",
            "telephone_number": "812-476-7111",
            "fax_number": "812-476-7117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR SPINE AND SPORTS MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-06",
        "last_updated": "2015-01-13",
        "status": "A",
        "authorized_official_last_name": "HASTETTER",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "KAY",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "812-476-7111"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "IN",
            "license": "01068416A",
            "primary": true
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "IN",
            "license": "01040195A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2015; 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.