Spine Surgery Service, PLLC

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

Legal business name

SPINE SURGERY SERVICE, PLLC

Practice address

17051 Dallas Pkwy Ste 400
Addison, TX 75001-7108

Phone

(210) 598-4262

NPI assigned

Aug 15, 2018

Organization subpart

No

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

Authorized official

Name

Michael Hennessy, MDNPI 1770795387

Title

MBR

Phone

(214) 370-3535

Specialties & licenses 1

Addresses

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.

• Michael Ware Hennessy, M.D.

  • Orthopaedic Surgery of the Spine Physician
  • Addison, TX
  • NPI 1770795387
  Authorized official Same address or phone

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

{
    "created_epoch": "1534291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694044800000",
    "number": "1902386477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1141 N LOOP 1604 E # 105-612",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782321339",
            "telephone_number": "201-598-4262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17051 DALLAS PKWY STE 400",
            "city": "ADDISON",
            "state": "TX",
            "postal_code": "750017108",
            "telephone_number": "210-598-4262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPINE SURGERY SERVICE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-15",
        "last_updated": "2023-09-07",
        "certification_date": "2023-09-07",
        "status": "A",
        "authorized_official_last_name": "HENNESSY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "MBR",
        "authorized_official_telephone_number": "214-370-3535",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Caroline Colette St. Matthews, CNIM
• Emily Ann Stanford
• Star Formula Inc (Star Medical Specialties)

• Surgical Physician Assistant in Addison, TX
• Providers in Addison, TX by specialty
• Surgical Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2023; 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.