NPIMap

Organization Active NPI

Ortho Sport and Spine Physicians Jackson

  • Physical Medicine & Rehabilitation Physician
  • Jackson, MS
National Provider Identifier
1891459616
Registry record updated Oct 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
ORTHO SPORT AND SPINE PHYSICIANS JACKSON
Practice address
4316 Old Canton Rd
Jackson, MS 39211-5995
Phone
(678) 752-7246
NPI assigned
Oct 27, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2021

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

Authorized official

Name
Faith A Beltzhoover
Title
Revenue Cycle Management Director
Phone
(678) 752-7246

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X Primary

Addresses

Primary practice location

4316 Old Canton Rd
Jackson, MS 39211-5995

Mailing address

5788 Roswell Rd Ste 100
Atlanta, GA 30328-4904
Phone (678) 752-7246

National Provider Directory

National Provider Directory
Tax ID family
Ortho Sport and Spine Physicians Milwaukee35 organizations share this tax ID, including this one

Other organizations with this tax ID 34

Organizations that report the same tax identification number in the National Provider Directory.

View all 34

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1635292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635292800000",
    "number": "1891459616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5788 ROSWELL RD STE 100",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303284904",
            "telephone_number": "678-752-7246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4316 OLD CANTON RD",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392115995",
            "telephone_number": "678-752-7246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHO SPORT AND SPINE PHYSICIANS JACKSON",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-27",
        "last_updated": "2021-10-27",
        "certification_date": "2021-10-27",
        "status": "A",
        "authorized_official_last_name": "BELTZHOOVER",
        "authorized_official_first_name": "FAITH",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "REVENUE CYCLE MANAGEMENT DIRECTOR",
        "authorized_official_telephone_number": "678-752-7246"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 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.