SOUTHLAKE ORTHOPAEDICS SPORTS MEDICINE & SPINE CENTER (NPI# 1518970722) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518970722 |
| Entity Type | Organization |
| Organization Name | SOUTHLAKE ORTHOPAEDICS SPORTS MEDICINE & SPINE CENTER |
| Other Organization Name | BRYANT AND BLUM ORTHOPAEDICS |
| Practice Address |
513 Brookwood Blvd Suite 402 Birmingham AL 35209-6862 |
| Mailing Address |
Po Box 830791 Birmingham AL 35283-0791 |
| Practice Telephone | 2058026898 |
| Practice Fax Number | 2058684596 |
| Mailing Telephone | 2059854111 |
| Mailing Fax Number | 2059854326 |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2009-07-23 |
| Authorized Official Name | MR. BARRY C GALLO (OFFICE ADMINSTRATOR) |
| 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 | DO482 | 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 |
| Other Name | Type Code |
|---|---|
| BRYANT AND BLUM ORTHOPAEDICS | Former Legal Business Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427061639 | Southlake Orthopaedics Sports Medicine & Spine Center | Orthopaedic Surgery | 1 Inverness Center Pkwy, Suite 204, Birmingham, AL 35242-4817 | 2006-08-15 |
| Street Address |
513 BROOKWOOD BLVD SUITE 402 |
| City | BIRMINGHAM |
| State | AL |
| Zip Code | 35209-6862 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073599023 | Unal Tutak | Anesthesiology | 513 Brookwood Blvd, Suite 101, Birmingham, AL 35209-6862 | 2005-12-21 |
| 1932608361 | Anesthesiology Services | Anesthesiology | 513 Brookwood Blvd, Suite 101, Birmingham, AL 35209 | 2018-02-12 |
| 1013458694 | Danielle Blackard | Nurse Practitioner | 513 Brookwood Blvd, Suite 401, Birmingham, AL 35209-6862 | 2017-03-15 |
| 1861848889 | Ashley Files | Nurse Practitioner | 513 Brookwood Blvd, Suite 401, Birmingham, AL 35209-6862 | 2016-05-09 |
| 1538520721 | Brookwood Diagnostic Imaging Center, LLC | Clinic/Center | 513 Brookwood Blvd, Suite 100, Birmingham, AL 35209-6878 | 2016-03-15 |
| 1790163053 | Erin Ann Esskuchen | Nurse Practitioner | 513 Brookwood Blvd, Suite 401, Birmingham, AL 35209-6862 | 2015-05-07 |
| 1447640628 | Rachel Messer | Nurse Practitioner | 513 Brookwood Blvd, Suite 275, Birmingham, AL 35209-6862 | 2015-01-27 |
| 1104258532 | Coretta H. Collins | Nurse Practitioner | 513 Brookwood Blvd, Suite 275, Birmingham, AL 35209-6862 | 2013-08-08 |
| 1154761310 | Brookwood Specialty Care Endocrinology, LLC | Internal Medicine | 513 Brookwood Blvd, Ste 400, Birmingham, AL 35209-6862 | 2013-07-02 |
| 1699017293 | Lauren Martin Gibson | Orthopaedic Surgery | 513 Brookwood Blvd, Suite 400, Birmingham, AL 35209-6862 | 2013-03-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437793510 | Marissa M Mcintyre | Registered Nurse | 3401 Independence Drive, Suite 221, Birmingham, AL 35209 | 2019-11-01 |
| 1093284457 | Patriot Healthcare of Alabama, LLC | Family Medicine | 2045 Brookwood Medical Center Drive, Suite 1, Birmingham, AL 35209 | 2018-11-15 |
| 1164902268 | Lucy Johnston | Physician Assistant | 1602 Woodfern Dr, Homewood, AL 35209 | 2018-08-17 |
| 1881184646 | Wade Louis Grady | Specialist/Technologist | 800 Larkshore Drive, Birmingham, AL 35209 | 2018-05-16 |
| 1154823029 | Taylor Payne | Physical Medicine & Rehabilitation | 109 Devon Dr, Birmingham, AL 35209 | 2018-03-06 |
| 1396251542 | 1st America Infusion Services LLC | Durable Medical Equipment & Medical Supplies | 120 Oxmoor Blvd Ste 100, Birmingham, AL 35209 | 2017-12-26 |
| 1376060954 | Hannah Holloway | Specialist/Technologist | 725 Crest Lane, Birmingham, AL 35209 | 2017-08-24 |
| 1558887463 | Paul A Rhodes | Nurse Practitioner | 631 Beacon Center Office Park, Suite 108, Birmingham, AL 35209 | 2017-08-22 |
| 1538542196 | Proteus Molecular and Clinical Lab LLC | Clinical Medical Laboratory | 218 Summit Pkwy, Suite 250, Homewood, AL 35209 | 2015-07-01 |
| 1124407739 | Randall Alban | Nurse Practitioner | 2100 Southbridge Parkway, Suite 650, Birmingham, AL 35209 | 2015-05-28 |
| Find all providers in zip 35209 | ||||
| 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 | 35209 |
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.