ADVANCED SPINE AND PAIN PLLC (NPI# 1215266267) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215266267 |
| Entity Type | Organization |
| Organization Name | ADVANCED SPINE AND PAIN PLLC |
| Practice Address |
450 Garrisonville Rd Suite 109 Stafford VA 22554 |
| Practice Telephone | 7035222727 |
| Practice Fax Number | 7035423753 |
| Mailing Telephone | 7035222727 |
| Mailing Fax Number | 7035423753 |
| Enumeration Date | 2009-12-21 |
| Last Update Date | 2017-12-12 |
| Authorized Official Name | MARY MARTELLONI (CREDENTIALER) |
| Authorized Official Telephone | 4106982665 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207X00000X | Orthopaedic Surgery | 0101243103 | VA | Allopathic & Osteopathic Physicians |
| N | 208VP0014X |
Pain Medicine Specialization: Interventional Pain Medicine |
0101243103 | VA | Allopathic & Osteopathic Physicians |
| Y | 207XS0117X |
Orthopaedic Surgery Specialization: Orthopaedic Surgery of the Spine |
0101243103 | VA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407478332 | Advanced Spine and Pain Pllc | Orthopaedic Surgery | 550 Ritchie Hwy Ste K, Severna Park, MD 21146-2953 | 2020-05-14 |
| 1144849100 | Advanced Spine and Pain Pllc | Orthopaedic Surgery | 1715 N George Mason Dr Ste 102, Arlington, VA 22205-3637 | 2020-04-10 |
| 1134748221 | Advanced Spine and Pain Pllc | Orthopaedic Surgery | 11230 Waples Mill Rd Ste 114c, Fairfax, VA 22030-5026 | 2020-04-09 |
| 1255695490 | Advanced Spine and Pain Pllc | Orthopaedic Surgery | 2046 Jefferson Davis Hwy, 103, Stafford, VA 22554-7276 | 2012-07-03 |
| 1134490311 | Advanced Spine and Pain Pllc | Orthopaedic Surgery | 1625 N George Mason Drive Suite 345, Arlington, VA 22205 | 2012-01-20 |
| 1609498179 | Advanced Spine and Pain Pllc | Orthopaedic Surgery | 3500 Boston St Ste J2, Baltimore, MD 21224-5251 | 2020-05-07 |
| 1225657281 | Advanced Spine and Pain Pllc | Orthopaedic Surgery | 2296 Opitz Blvd Ste 210, Woodbridge, VA 22191-3345 | 2020-04-10 |
| 1437627080 | Advanced Spine and Pain Pllc | Anesthesiology | 11760 S 700 E Ste 112, Draper, UT 84020-6605 | 2018-11-12 |
| 1659722882 | Advanced Spine and Pain Pllc | Anesthesiology | 22255 Greenfield Rd, Suite 500, Southfield, MI 48075-3710 | 2016-06-29 |
| 1831467166 | Advanced Spine and Pain Pllc | Orthopaedic Surgery | 450 Garrisonville Rd, Suite 109, Stafford, VA 22554 | 2011-12-01 |
| Street Address |
450 GARRISONVILLE RD SUITE 109 |
| City | STAFFORD |
| State | VA |
| Zip Code | 22554 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518967207 | Thomas J Raley | Orthopaedic Surgery | 450 Garrisonville Rd, Suite 109, Stafford, VA 22554 | 2005-07-26 |
| 1073057741 | Sebastian M Bouroncle Dds-2 Stafford Pllc | Dentist | 450 Garrisonville Rd, Suite# 201, Stafford, VA 22554-1532 | 2016-12-14 |
| 1407101090 | Taylor A Mckinney | Physical Therapist | 450 Garrisonville Rd, Stafford, VA 22554-1532 | 2012-07-19 |
| 1831467166 | Advanced Spine and Pain Pllc | Orthopaedic Surgery | 450 Garrisonville Rd, Suite 109, Stafford, VA 22554 | 2011-12-01 |
| 1831423839 | Galadriel Lea Pastor | Physician Assistant | 450 Garrisonville Rd, Suite 109, Stafford, VA 22554 | 2009-09-23 |
| 1265687305 | James Huang | Physical Medicine & Rehabilitation | 450 Garrisonville Rd, 109, Stafford, VA 22554 | 2008-11-17 |
| 1336305002 | Vipul Mangal | Anesthesiology | 450 Garrisonville Rd, Suite 109, Stafford, VA 22554-1532 | 2008-08-01 |
| 1073559969 | Carolina Maria Hernandez | Internal Medicine | 450 Garrisonville Rd, Suite 215, Stafford, VA 22554-1532 | 2006-06-21 |
| 1023096054 | Kevin Dale Moore | Psychiatry & Neurology | 450 Garrisonville Rd, 109, Stafford, VA 22554 | 2006-01-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699385658 | Publix North Carolina, Lp | Durable Medical Equipment & Medical Supplies | 1640 Publix Way, Stafford, VA 22554 | 2020-08-05 |
| 1700368156 | Aws Altameemi | Dentist | 392 Garrisonville Road 205, Stafford, VA 22554 | 2018-09-02 |
| 1831680214 | Radka Loucka | Counselor | 2124 Jefferson Davis Highway, Suite 202, Stafford, VA 22554 | 2018-05-22 |
| 1205383718 | Ogiawesome | Non-emergency Medical Transport (VAN) | 109 Chesterbrook Court, Stafford, VA 22554 | 2016-09-01 |
| 1184088502 | Inina Plucer-rosario | Behavioral Analyst | 12 Monument Drive, Stafford, VA 22554 | 2016-04-12 |
| 1528451218 | Insight Psychological Services, Pllc | Counselor | 11 Hope Rd., Suite 213, Stafford, VA 22554 | 2015-03-05 |
| 1194142885 | Krystal Karin Edmonds | Behavioral Analyst | 538 Apricot Street, Stafford, VA 22554 | 2014-03-20 |
| 1851715312 | Maryann Byrne | Counselor | 108 Brandice St, Stafford, VA 22554 | 2014-02-04 |
| 1164857272 | Melissa C Keylor | Counselor | 11 Hope Road, Suite 213, Stafford, VA 22554 | 2013-09-09 |
| 1255777959 | Sophia Rodrigues | Physical Therapist | 2777 Jefferson Davis Hwy, Suite 109, Performance Physical Therapy, Stafford, VA 22554 | 2013-05-21 |
| Find all providers in zip 22554 | ||||
| Taxonomy Code | 207XS0117X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Orthopaedic Surgery of the Spine |
| Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, orthopaedic surgeons of the spine deal with the evaluation and nonoperative and operative treatment of the full spectrum of primary spinal disorders including trauma, degenerative, deformity, tumor, and reconstructive. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Separate board certification is not currently offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255695490 | Advanced Spine and Pain Pllc | Orthopaedic Surgery | 2046 Jefferson Davis Hwy, 103, Stafford, VA 22554-7276 | 2012-07-03 |
| 1831467166 | Advanced Spine and Pain Pllc | Orthopaedic Surgery | 450 Garrisonville Rd, Suite 109, Stafford, VA 22554 | 2011-12-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548883192 | Spine Center PC | Orthopaedic Surgery | 2726 Electric Rd Ste 203a, Roanoke, VA 24018-3528 | 2020-05-18 |
| 1992299598 | Hasz Spine Institute PC | Orthopaedic Surgery | 1830 Town Center Dr Ste 102, Reston, VA 20190-3216 | 2018-06-18 |
| 1881188506 | Nikhil Jain | Orthopaedic Surgery | 1215 Lee St - Box Number 800159, Charlottesville, VA 22908-0816 | 2018-06-16 |
| 1922516806 | Joint Replacement Cin of Northern Virginia LLC | Orthopaedic Surgery | 1900 Campus Commons Dr Ste 100a, Reston, VA 20191-1561 | 2018-01-13 |
| 1134562051 | Elliott Jiwoo Kim | Orthopaedic Surgery | 1635 N George Mason Dr Ste 310, Arlington, VA 22205-3616 | 2013-04-10 |
| 1134490311 | Advanced Spine and Pain Pllc | Orthopaedic Surgery | 1625 N George Mason Drive Suite 345, Arlington, VA 22205 | 2012-01-20 |
| 1831426204 | Maryview Hospital | Orthopaedic Surgery | 5838 Harbour View Blvd Ste 100, Suffolk, VA 23435-2663 | 2009-11-05 |
| 1144403262 | Kirven Orthopedic Group, P.C. | Orthopaedic Surgery | 5701 Cleveland Street, Suite 600, Virginia Beach, VA 23462 | 2007-12-12 |
| 1699859058 | Adel S Kebaish | Orthopaedic Surgery | 7787 Leesburg Pike, B, Falls Church, VA 22043-2412 | 2006-10-24 |
| 1063469393 | Sohail K Mirza | Orthopaedic Surgery | 4250 Chain Bridge Rd, Fairfax, VA 22030-4214 | 2006-05-30 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.