SOUTHLAKE ORTHOPAEDICS SPORTS MEDICINE & SPINE CENTER (NPI# 1427061639) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427061639 |
| Entity Type | Organization |
| Organization Name | SOUTHLAKE ORTHOPAEDICS SPORTS MEDICINE & SPINE CENTER |
| Other Organization Name | BRYANT AND BLUM ORTHOPAEDICS |
| Practice Address |
1 Inverness Center Pkwy Suite 204 Birmingham AL 35242-4817 |
| Mailing Address |
Po Box 830791 Birmingham AL 35283-0791 |
| Practice Telephone | 2055035544 |
| Practice Fax Number | 2055035543 |
| Mailing Telephone | 2059854111 |
| Mailing Fax Number | 2059854326 |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2008-05-05 |
| Authorized Official Name | MR. BARRY GALLO (OFFICE ADMINISTRATOR) |
| Authorized Official Telephone | 2059854111 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207X00000X | Orthopaedic Surgery | 15203 | AL | Allopathic & Osteopathic Physicians |
| N | 207X00000X | Orthopaedic Surgery | 19103 | AL | Allopathic & Osteopathic Physicians |
| N | 207X00000X | Orthopaedic Surgery | 11656 | AL | Allopathic & Osteopathic Physicians |
| N | 207X00000X | Orthopaedic Surgery | 21044 | AL | Allopathic & Osteopathic Physicians |
| N | 208100000X | Physical Medicine & Rehabilitation | 21044 | AL | Allopathic & Osteopathic Physicians |
| N | 225X00000X | Occupational Therapist | 3835 | AL | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| N | 225X00000X | Occupational Therapist | 2253 | AL | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| N | 225X00000X | Occupational Therapist | 0850 | AL | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
TA-1605 | AL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AL | DR. WILLIAM KRAUSS NPI # | 1780639492 | 01 |
| AL | NITA N. HARRIS NPI # | 1750339115 | 01 |
| AL | DR. MICHAEL BLUM NPI # | 1518915016 | 01 |
| AL | ANDREA MOORE NPI # | 1457453052 | 01 |
| AL | SOUTHLAKE ORTHOPAEDICS NP | 1043268402 | 01 |
| AL | DR. EKKEHARD BONATZ NPI # | 1164470381 | 01 |
| AL | SUSAN BROWN NPI # | 1538114251 | 01 |
| AL | DR. C.J. TALBERT NPI # | 1629026158 | 01 |
| AL | DR. M ELLERBUSCH NPI # | 1437107984 | 01 |
| AL | STEPHANIE REYNER NPI # | 1487673604 | 01 |
| Other Name | Type Code |
|---|---|
| BRYANT AND BLUM ORTHOPAEDICS | Former Legal Business Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518970722 | Southlake Orthopaedics Sports Medicine & Spine Center | Orthopaedic Surgery | 513 Brookwood Blvd, Suite 402, Birmingham, AL 35209-6862 | 2006-08-15 |
| Street Address |
1 INVERNESS CENTER PKWY SUITE 204 |
| City | BIRMINGHAM |
| State | AL |
| Zip Code | 35242-4817 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568471548 | Alvin B Cohn | Plastic Surgery | 1 Inverness Center Pkwy, Suite 100, Birmingham, AL 35242-4817 | 2006-08-07 |
| 1447643523 | Shelby Oral Facial Surgery | Dentist | 1 Inverness Center Pkwy, Suite 200, Birmingham, AL 35242-4817 | 2015-03-12 |
| 1649660713 | Everts, Livingston and Miller Surgical Services, PC | Dentist | 1 Inverness Center Pkwy, Suite 200, Birmingham, AL 35242-4817 | 2015-01-28 |
| 1134543499 | Amelia Shea Hill | Registered Nurse | 1 Inverness Center Pkwy, Birmingham, AL 35242-4817 | 2014-02-06 |
| 1245519875 | Al Cohn, Md PC | Plastic Surgery | 1 Inverness Center Pkwy, Suite 100, Birmingham, AL 35242-4817 | 2011-08-13 |
| 1528119518 | James C Grotting | Plastic Surgery | 1 Inverness Center Pkwy, Suite 100, Birmingham, AL 35242-4817 | 2007-01-16 |
| 1588715569 | James C. Grotting, Md, PC | Plastic Surgery | 1 Inverness Center Pkwy, Suite 100, Birmingham, AL 35242-4817 | 2007-01-16 |
| 1285743401 | Elizabeth Bernier | Physical Therapist | 1 Inverness Center Pkwy, Ste 200, Birmingham, AL 35242-4817 | 2006-08-30 |
| 1861501512 | Michael Rogers | Physical Therapist | 1 Inverness Center Pkwy, Ste 200, Birmingham, AL 35242-4817 | 2006-08-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558960138 | A Friend of Mind | Behavioral Analyst | 5271 Harvest Ridge Ln, Birmingham, AL 35242 | 2020-10-23 |
| 1295347789 | Restore Therapy Services, Ltd | Physical Therapist | 6328 Farley Lane, Birmingham, AL 35242 | 2020-08-18 |
| 1447894175 | Publix Alabama, LLC | Durable Medical Equipment & Medical Supplies | 3201 Endeavor Lane, Vestavia Hills, AL 35242 | 2019-11-06 |
| 1952956468 | Publix Alabama, LLC | Durable Medical Equipment & Medical Supplies | 6219 Tattersall Blvd., Hoover, AL 35242 | 2019-08-02 |
| 1033670120 | Rachel Monahan -patterson | Registered Nurse | 7191 Cahaba Valley Road, Suite 300, Birmingham, AL 35242 | 2019-03-29 |
| 1891283818 | Elizabeth Mcrae | Counselor | 150 Glenwood Lane, Birmingham, AL 35242 | 2018-04-25 |
| 1326549429 | Mary Virginia Colvert | Nurse Practitioner | 200 Riverhill Business Park, #250, Birmingham, AL 35242 | 2018-02-23 |
| 1669980504 | Liberty Park Anesthesia Services, LLC | Nurse Anesthetist, Certified Registered | 1940 Stonegate Dr Ste 30, Vestavia Hls, AL 35242 | 2018-01-12 |
| 1942710983 | Southern Dental Sleep Specialists LLC | Clinic/Center | 4960 Valleydale Rd Ste 100, Birmingham, AL 35242 | 2017-10-04 |
| 1922526557 | Sarah Katherine Fleming | Specialist/Technologist | 1524 Southern Drive, Birmingham, AL 35242 | 2017-09-04 |
| Find all providers in zip 35242 | ||||
| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710520192 | Orthosports Associates, LLC | Orthopaedic Surgery | 7191 Cahaba Valley Rd Ste 200b, Birmingham, AL 35242-6443 | 2019-10-18 |
| 1639576887 | Jason D. Cobb, Md, LLC | Orthopaedic Surgery | 52 Medical Park Dr E Ste 220, Birmingham, AL 35235-3428 | 2014-12-02 |
| 1649614330 | Furnie Wesley Johnston | Orthopaedic Surgery | 3328 East Briarcliff, Birmingham, AL 35223 | 2013-04-24 |
| 1013227222 | Orthopaedic Specialists of Alabama, PC | Orthopaedic Surgery | 720 Montclair Rd., Ste. 200, Birmingham, AL 35213-1964 | 2010-10-21 |
| 1336459528 | Orthopaedic Specialists of Alabama, PC | Orthopaedic Surgery | 801 Princeton Dr., Ste. 710, Birmingham, AL 35211-1309 | 2010-10-21 |
| 1285944405 | Orthopaedic Specialists of Alabama, PC | Orthopaedic Surgery | 833 St. Vincent's Dr., Ste. 403, Birmingham, AL 35205-1614 | 2010-10-21 |
| 1518161504 | Rebecca Anne Moul | Orthopaedic Surgery | 4600 Highway 280 Ste 200, Birmingham, AL 35242-5186 | 2007-06-13 |
| 1457560245 | Ashley Reed Estes | Orthopaedic Surgery | 833 St. Vincent's Drive, Building 3, Suite 403, Birmingham, AL 35205-1614 | 2007-05-21 |
| 1275748428 | Michael David Johnson | Orthopaedic Surgery | 1313 13th St S, Suite 211, Birmingham, AL 35205-5327 | 2007-05-11 |
| 1568516151 | Southern Orthopaedic Specialists, P.C. | Orthopaedic Surgery | 516 Brookwood Blvd, Floor 2, Birmingham, AL 35209-6802 | 2007-01-22 |
| Find all providers in BIRMINGHAM | ||||
| City | BIRMINGHAM |
| Zip Code | 35242 |
Please comment or provide details below to improve the information on SOUTHLAKE ORTHOPAEDICS SPORTS MEDICINE & SPINE CENTER.
| 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.