SPINE CIN OF PHILADELPHIA LLC (NPI# 1508365446) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508365446 |
| Entity Type | Organization |
| Organization Name | SPINE CIN OF PHILADELPHIA LLC |
| Practice Address |
1700 Market St Ste 1005b216 Philadelphia PA 19103-3913 |
| Mailing Address |
102 Woodmont Blvd Ste 350 Nashville TN 37205-2216 |
| Practice Telephone | 6153860064 |
| Practice Fax Number | 6153860067 |
| Mailing Telephone | 6153860064 |
| Mailing Fax Number | 6153860067 |
| Enumeration Date | 2018-02-06 |
| Last Update Date | 2019-12-26 |
| Authorized Official Name | EDWARD LELAND HUTTON EADIE (DIRECTOR) |
| Authorized Official Telephone | 6157332064 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207XS0117X |
Orthopaedic Surgery Specialization: Orthopaedic Surgery of the Spine |
PA | Allopathic & Osteopathic Physicians | |
| Y | 207X00000X | Orthopaedic Surgery | PA | Allopathic & Osteopathic Physicians |
| Street Address |
1700 MARKET ST STE 1005B216 |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19103-3913 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427511195 | Spa Care of Penn, LLC | Orthopaedic Surgery | 1700 Market St Ste 1005b216, Philadelphia, PA 19103-3913 | 2019-04-10 |
| 1356804025 | Spa Care of Penn II, LLC | Orthopaedic Surgery | 1700 Market St Ste 1005b216, Philadelphia, PA 19103-3913 | 2019-04-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518565431 | Allyson Caputa | Behavior Technician | 100 North 18th Street, Suite 300, Philadelphia, PA 19103 | 2020-10-13 |
| 1063062685 | Sarah Seeling | Social Worker | 255 South 17th Street Suite 1010, Suite 1500, Suite 23, Philadelphia, PA 19103 | 2019-09-16 |
| 1730735051 | Jill Verofsky | Counselor | 1180 Jfk Blvd, Suite 1110, Philadelphia, PA 19103 | 2019-08-13 |
| 1932761863 | Barclay Prescription Pharmacy | Pharmacist | 1736 Spruce St, Phila, PA 19103 | 2019-07-01 |
| 1265910459 | Whitney Sue Fricke | Counselor | 2211 Locust St, Philadelphia, PA 19103 | 2018-07-31 |
| 1740784586 | Sara Elizabeth Macintyre | Speech-Language Pathologist | 1845 Walnut Street Suite 1540, Philadelphia, PA 19103 | 2018-03-19 |
| 1326578907 | Danielle D Bercovitch | Speech-Language Pathologist | 1930 S Broad, Philadelphia, PA 19103 | 2017-06-15 |
| 1598114449 | Brooke Elaine Mullen | Dietitian, Registered | 1708 Pine St Apt 1r, Philadelphia, PA 19103 | 2016-06-10 |
| 1972966026 | Alexandra Brady Jatzke | Dietitian, Registered | 1835 Market St Fl 2, Philadelphia, PA 19103 | 2016-04-05 |
| 1932574118 | David Clements Iv | Psychiatry & Neurology | 1845 Walnut St Ste 1540, Philadelphia, PA 19103 | 2015-12-14 |
| Find all providers in zip 19103 | ||||
| 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 |
|---|---|---|---|---|
| 1932708492 | Sunnyvale Orthopaedic and Rehabilitation Clinic | Orthopaedic Surgery | 1419 N 75th St, Philadelphia, PA 19151-2901 | 2020-10-25 |
| 1770120537 | Marcel Orthopedics LLC | Orthopaedic Surgery | 3717 Chestnut St Apt 202.m, Philadelphia, PA 19104-3164 | 2019-11-28 |
| 1639632185 | Taylor D'amore | Orthopaedic Surgery | 925 Chest Street 5th Floor, Philadelphia, PA 19107 | 2019-04-11 |
| 1295245694 | Hr Physician Services | Orthopaedic Surgery | 7500 Central Ave Ste 108, Philadelphia, PA 19111-2431 | 2017-10-11 |
| 1760912372 | Qingwu Kong | Orthopaedic Surgery | 230 N Broad St., Philadelphia, PA 19102 | 2017-06-15 |
| 1467981647 | Colin Ackerman | Orthopaedic Surgery | 3401 N Broad St Fl 5, Philadelphia, PA 19140-5103 | 2017-06-09 |
| 1790104578 | Talia Chapman | Orthopaedic Surgery | 1015 Chestnut St Ste 801, Philadelphia, PA 19107-4308 | 2014-04-09 |
| 1285991091 | Grant H Garcia | Orthopaedic Surgery | 23 S 23rd St Unit 3l, Philadelphia, PA 19103 | 2012-04-18 |
| 1598053365 | Amrit Singh Khalsa | Orthopaedic Surgery | 3737 Market St Fl 8, Philadelphia, PA 19104-5545 | 2011-07-14 |
| 1568752392 | Matthew Steven Wilson | Orthopaedic Surgery | 834 Chestnut Street, Suite G-114, The Philadelphia Hand Center, Philadelphia, PA 19107 | 2011-04-13 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19103 |
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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.