SOUTHLAKE ORTHOPAEDICS SPORTS MEDICINE & SPINE CENTER PC (NPI# 1497371405) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1497371405 |
Entity Type | Organization |
Organization Name | SOUTHLAKE ORTHOPAEDICS SPORTS MEDICINE & SPINE CENTER PC |
Practice Address |
3686 Grandview Pkwy Ste 430 Birmingham AL 35243-3404 |
Mailing Address |
4517 Southlake Pkwy Hoover AL 35244-3280 |
Practice Telephone | 2056058180 |
Practice Fax Number | 2059728785 |
Mailing Telephone | 2059854111 |
Mailing Fax Number | 2059854326 |
Enumeration Date | 2020-06-25 |
Last Update Date | 2020-06-25 |
Authorized Official Name | ROBERT CRABTREE (ADMINISTRATOR) |
Authorized Official Telephone | 2053297542 |
Is Organization Subpart | Y |
Parent Organization Name | SOUTHLAKE ORTHOPAEDICS SPORTS MEDICINE & SPINE CENTER PC |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207RS0010X |
Internal Medicine Specialization: Sports Medicine |
Allopathic & Osteopathic Physicians | ||
N | 207XS0106X |
Orthopaedic Surgery Specialization: Hand Surgery |
Allopathic & Osteopathic Physicians | ||
N | 207XS0117X |
Orthopaedic Surgery Specialization: Orthopaedic Surgery of the Spine |
Allopathic & Osteopathic Physicians | ||
N | 207XX0004X |
Orthopaedic Surgery Specialization: Foot and Ankle Surgery |
Allopathic & Osteopathic Physicians | ||
N | 208100000X | Physical Medicine & Rehabilitation | Allopathic & Osteopathic Physicians | ||
N | 222Z00000X | Orthotist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
N | 224P00000X | Prosthetist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
N | 225100000X | Physical Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
N | 225X00000X | Occupational Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
N | 2471C3402X |
Radiologic Technologist Specialization: Radiography |
Technologists, Technicians & Other Technical Service Providers | ||
N | 2471M1202X |
Radiologic Technologist Specialization: Magnetic Resonance Imaging |
Technologists, Technicians & Other Technical Service Providers | ||
N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
Y | 207X00000X | Orthopaedic Surgery | Allopathic & Osteopathic Physicians |
Other Name | Type Code |
---|---|
Bryant and Blum | Former Legal Business Name - Organization |
Southlake Orthopaedics | Doing Business As Name - Organization |
Address | Telephone Number | Fax Number |
---|---|---|
4517 Southlake Pkwy, Hoover, AL 352443280 | 2059854111 | 2059854326 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1356704654 | Southlake Orthopaedics Sports Medicine & Spine Center PC | Physical Therapist | 4517 Southlake Pkwy, Hoover, AL 35244-3280 | 2016-04-04 |
1043268402 | Southlake Orthopaedics Sports Medicine & Spine Center PC | Specialist | 4517 Southlake Pkwy, Birmingham, AL 35244-3280 | 2006-05-05 |
Street Address |
3686 GRANDVIEW PKWY STE 430 |
City | BIRMINGHAM |
State | AL |
Zip Code | 35243-3404 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1588205223 | See Inc | Optometrist | 200 Summit Blvd, Suite 168, Birmingham, AL 35243 | 2019-10-03 |
1619526829 | Kourtni Brooke Young | Nurse Anesthetist, Certified Registered | Grandview Medical Center, 3690 Grandview Parkway, Birmingham, AL 35243 | 2019-09-10 |
1548747942 | Kaitlyn Bennett | Occupational Therapist | 3140 Cahaba Heights Road, Suite 102, Vestavia, AL 35243 | 2018-07-27 |
1013407675 | Alabama Radiation Therapy Services | Radiology | 3670 Grandview Pkwy #100, Birmingham, AL 35243 | 2018-05-18 |
1184169559 | Olivia Diann Gaston | Behavioral Analyst | 3296 Cahaba Heights Rd., Milestones Behavior Group., Vestavia, AL 35243 | 2016-12-21 |
1679027841 | Aspire Physical Recovery Center At Cahaba River, LLC | Skilled Nursing Facility | 3070 Healthy Way, Vestavia, AL 35243 | 2016-08-05 |
1306203682 | Abbey Elizabeth Duke | Physician Assistant | 3690 Grandview Parkway, Birmingham, AL 35243 | 2016-01-18 |
1689078628 | Mary Camp | Occupational Therapist | 3140 Cahaba Heights Road Suite 102, Vestavia Hills, AL 35243 | 2014-10-20 |
1255757209 | Laura Romundstad | Nurse Practitioner | 3670 Grandview Parkway, Suite 100, Birmingham, AL 35243 | 2014-03-14 |
1841631199 | Seth Alexander Martin | Developmental Therapist | 3981 Kyle Lane, Milestones Behavior Consulting, Vestavia, AL 35243 | 2013-07-16 |
Find all providers in zip 35243 |
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 | 35243 |
Please comment or provide details below to improve the information on SOUTHLAKE ORTHOPAEDICS SPORTS MEDICINE & SPINE CENTER PC.
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.