NPIMap

Organization Active NPI

Southwest Spine and Pain Care Specialists, LLC

Doing business as Vista Spine Sports and Injury Center

  • Chiropractor
  • St George, UT
National Provider Identifier
1871263178
Registry record updated Sep 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
SOUTHWEST SPINE AND PAIN CARE SPECIALISTS, LLC
Doing business as
Vista Spine Sports and Injury Center
Practice address
2891 E Mall Drive
Ste 200
Saint George, UT 84790
Phone
(435) 688-1665
Fax
(435) 619-8634
NPI assigned
Sep 17, 2021
Last updated
Sep 17, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
SOUTHWEST SPINE AND PAIN CARE SPECIALISTS, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 17, 2021

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

Authorized official

Name
Jon B Obray, MDNPI 1205814803
Title
Managing Partner
Phone
(435) 215-0230

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X NU Primary
Physical Therapist 225100000X NU

Addresses

Primary practice location

2891 E Mall Drive
Ste 200
Saint George, UT 84790

Mailing address

PO Box 912042
St George, UT 84791-2042
Phone (435) 215-0230

Other names 1

  • Vista Spine Sports and Injury Center Doing business as

National Provider Directory

National Provider Directory
Part of
SW Spine and Pain Care SPC

Locations

2311 N Main St
Ste 101
Cedar City, UT 84721
Phone (435) 233-7375

35 S 5th E
Heber City, UT 84032
Phone (435) 654-1501

630 E 1400 N
#125
Logan, UT 84341
Phone (435) 787-8146

630 E 1400 N
Ste 120
Logan, UT 84341
Phone (435) 787-7246

15 S 1000 E
Ste 125
Payson, UT 84651
Phone (801) 465-2559

24 W Sergeant Court Dr
Bldg 1
Saratoga Springs, UT 84045
Phone (385) 336-1157

62 E Thrive Dr
Ste 200
Saratoga Springs, UT 84045
Phone (385) 336-1157

1085 S Bluff St
Ste 200
St George, UT 84770
Phone (435) 218-7778

2051 E Red Hills Pkwy
Ste 7
St George, UT 84770
Phone (435) 703-2930

359 E Riverside Dr
St George, UT 84790
Phone (435) 619-8632

652 S Medical Center Dr
Ste 110
St George, UT 84790
Phone (435) 215-0230

Practitioners & affiliated clinicians

Practitioners 41

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.

View all 41

NPI Registry JSON

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

{
    "created_epoch": "1631836800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631836800000",
    "number": "1871263178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 912042",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847912042",
            "telephone_number": "435-215-0230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2891 E MALL DRIVE",
            "address_2": "STE 200",
            "city": "SAINT GEORGE",
            "state": "UT",
            "postal_code": "84790",
            "telephone_number": "435-688-1665",
            "fax_number": "435-619-8634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST SPINE AND PAIN CARE SPECIALISTS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTHWEST SPINE AND PAIN CARE SPECIALISTS, LLC",
        "enumeration_date": "2021-09-17",
        "last_updated": "2021-09-17",
        "certification_date": "2021-09-01",
        "status": "A",
        "authorized_official_last_name": "OBRAY",
        "authorized_official_first_name": "JON",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "435-215-0230",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vista Spine Sports and Injury Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in St George, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2021; 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.