NPIMap

Organization Active NPI

Spine Group Fyzical LLC

  • Physical Therapist
  • Gardendale, AL
National Provider Identifier
1942008479
Registry record updated Mar 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
SPINE GROUP FYZICAL LLC
Practice address
835 Odum Rd Ste 101
Gardendale, AL 35071-4111
Phone
(205) 285-8585
Fax
(205) 285-8686
NPI assigned
Mar 3, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2025

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

Authorized official

Name
Mr. Dustin M Clary, PTNPI 1053400184
Title
Owner
Phone
(205) 349-9494

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

835 Odum Rd Ste 101
Gardendale, AL 35071-4111

Mailing address

198 Medical Center Dr
Prattville, AL 36066-7286
Phone (334) 313-8990

Other names 1

  • Fyzical Gardendale Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250422000555 AL Part B Supplier - Physical/Occupational Therapy Group in Private Practice 7315462462 Receives reassigned benefits from 4 practitioners
Practice locations: Gardendale, AL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1740960000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740960000000",
    "number": "1942008479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "198 MEDICAL CENTER DR",
            "city": "PRATTVILLE",
            "state": "AL",
            "postal_code": "360667286",
            "telephone_number": "334-313-8990",
            "fax_number": "334-730-0499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "835 ODUM RD STE 101",
            "city": "GARDENDALE",
            "state": "AL",
            "postal_code": "350714111",
            "telephone_number": "205-285-8585",
            "fax_number": "205-285-8686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPINE GROUP FYZICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-03",
        "last_updated": "2025-03-03",
        "certification_date": "2025-03-03",
        "status": "A",
        "authorized_official_last_name": "CLARY",
        "authorized_official_first_name": "DUSTIN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "205-349-9494",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fyzical Gardendale",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gardendale, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.