Gulf Coast Interventional Spine & Joint Specialists LLC

Primary specialty

Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X

License

MD.29601 Issued in AL

Legal business name

GULF COAST INTERVENTIONAL SPINE & JOINT SPECIALISTS LLC

Practice address

1557 Spring Hill Ave
Mobile, AL 36604-3218

Phone

(251) 478-4900

Fax

(251) 470-6221

NPI assigned

Jun 29, 2015

Last updated

Oct 2, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tao Chen, MDNPI 1316130743

Title

Physician/Owner

Phone

(251) 478-4900

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AL2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

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.

• Tao Chen, MD

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Mobile, AL
  • NPI 1316130743
  Medicare reassignment NPD Authorized official
• Shay Ellard Bruton, AGNP-C

  • Gerontology Nurse Practitioner
  • Mobile, AL
  • NPI 1346085909
  NPD

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

{
    "created_epoch": "1435536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696204800000",
    "number": "1952783748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1557 SPRING HILL AVE",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366043218",
            "telephone_number": "251-478-4900",
            "fax_number": "251-470-6221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1557 SPRING HILL AVE",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366043218",
            "telephone_number": "251-478-4900",
            "fax_number": "251-470-6221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GULF COAST INTERVENTIONAL SPINE & JOINT SPECIALISTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-29",
        "last_updated": "2023-10-02",
        "certification_date": "2023-10-02",
        "status": "A",
        "authorized_official_last_name": "CHEN",
        "authorized_official_first_name": "TAO",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "251-478-4900",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "AL",
            "license": "MD.29601",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "182860",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gulf Coast Dermatology & Skin Care Centre PLLC (Advanced Dermatology & Skin Care Centre)
• Gulf Coast Dermatology & Skin Care Centre PLLC (Advanced Dermatology & Skin Care Centre)
• Gulf Coast Dermatology & Skin Care Centre PLLC (Advanced Dermatology & Skin Care Centre)
• Gulf Coast Health and Rehabilitation, LLC
• Gulf Coast Homecare LLC Dba Firstlight Homecare of Mobile Eastern Shor (FirstLight Homecare Emerald Coast)
• Gulf Coast Medicine LLC (Gulf Coast Medicine)
• Gulf Coast Mens Clinic
• Gulf Coast Optometry
• Gulf Coast Pain Consultants LLC (Clearway Pain Solutions Institute)
• Gulf Coast Patient Care Network, Inc

• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Mobile, AL
• Providers in Mobile, AL by specialty
• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.