Injury and Spine Medical Group, LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

INJURY AND SPINE MEDICAL GROUP, LLC

Practice address

7824 Lake Underhill Rd Ste I
Orlando, FL 32822-8201

Phone

(407) 601-1210

Fax

(407) 601-2504

NPI assigned

Aug 10, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Keith Massi, D.C.

Title

President

Phone

(407) 538-2233

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1470787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589500800000",
    "number": "1891249579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 422210",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347422210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7824 LAKE UNDERHILL RD STE I",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328228201",
            "telephone_number": "407-601-1210",
            "fax_number": "407-601-2504"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3724 Winter Garden Vineland Rd Bldg 2",
            "address_purpose": "LOCATION",
            "city": "Winter Garden",
            "state": "FL",
            "postal_code": "347875483",
            "country_code": "US",
            "telephone_number": "407-601-1210",
            "fax_number": "407-601-2504",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "INJURY AND SPINE MEDICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-10",
        "last_updated": "2020-05-15",
        "certification_date": "2020-05-15",
        "status": "A",
        "authorized_official_last_name": "MASSI",
        "authorized_official_first_name": "KEITH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "407-538-2233",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 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.