ADVANCED SPINE ASSOCIATES PA (NPI# 1548253933) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548253933 |
| Entity Type | Organization |
| Organization Name | ADVANCED SPINE ASSOCIATES PA |
| Practice Address |
8232 Highway 65 Ne Spring Lake Park MN 55432-2095 |
| Practice Telephone | 7635771877 |
| Practice Fax Number | 7635771887 |
| Mailing Telephone | 7635771877 |
| Mailing Fax Number | 7635771887 |
| Enumeration Date | 2005-08-31 |
| Last Update Date | 2012-12-17 |
| Authorized Official Name | DR. GARRY M BANKS (M.D.) |
| Authorized Official Telephone | 7635771877 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2081P2900X |
Physical Medicine & Rehabilitation Specialization: Pain Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 225100000X | Physical Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| Y | 207XS0117X |
Orthopaedic Surgery Specialization: Orthopaedic Surgery of the Spine |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 713523800 | 05 |
| Street Address |
8232 HIGHWAY 65 NE |
| City | SPRING LAKE PARK |
| State | MN |
| Zip Code | 55432-2095 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578059408 | Lakes Area Health Center, Pllc | Physical Therapist | 8232 Highway 65 Ne, Spring Lake Park, MN 55432-2095 | 2018-07-03 |
| 1467948398 | Lakes Area Health Center, Pllc | General Practice | 8232 Highway 65 Ne, Spring Lake Park, MN 55432-2095 | 2018-07-03 |
| 1508390527 | Lakes Area Health Center | Clinic/Center | 8232 Highway 65 Ne, Spring Lake Park, MN 55432-2095 | 2017-04-17 |
| 1528353711 | Shauna Marissa Pankratz | Physician Assistant | 8232 Highway 65 Ne, Spring Lake Park, MN 55432-2095 | 2011-06-15 |
| 1518913359 | Candace K Pella | Physical Therapist | 8232 Highway 65 Ne, Spring Lake Park, MN 55432-2022 | 2006-05-25 |
| 1972554384 | David P Kraker | Orthopaedic Surgery | 8232 Highway 65 Ne, Spring Lake Park, MN 55432-2095 | 2006-05-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336791177 | Adelyn Ruth Kopp | Occupational Therapist | 500 Osborne Rd Ne Suite 365, Fridley, MN 55432 | 2019-07-11 |
| 1831665603 | White Smiles Family Dentistry Pllc | Dentist | 1611 County Hwy 10, Minneapolis, MN 55432 | 2018-10-19 |
| 1518402213 | Peaceful Adult Day Center LLC. | Home Health | 6267 University Ave Ne, Fridley, MN 55432 | 2017-01-04 |
| 1205383742 | Farhiya Mahamud Gelle I | Durable Medical Equipment & Medical Supplies | 6329 5th Street Ne Apt 8, Fridley, MN 55432 | 2016-09-01 |
| 1093163164 | Christiane Schwecke | Specialist/Technologist | 8290 University Ave N, Fridley, MN 55432 | 2016-05-31 |
| 1336551563 | Amy White Mountain | Massage Therapist | 1611 County Hwy 10 Ne, Spring Lake Park, MN 55432 | 2014-05-22 |
| 1942629795 | Shane O'neil | Dermatology | 500 Osborne Rd Ne Ste 330, Fridley, MN 55432 | 2014-04-09 |
| 1952648180 | John Franklyn Marshall | Family Medicine | 480 Osborne Road Ne, Suite 100, Fridley, MN 55432 | 2013-01-08 |
| 1558610519 | Novacare Outpatient Rehabilitation East Inc | Clinic/Center | 480 Osborne Road, Number 280, Fridley, MN 55432 | 2012-09-06 |
| 1336423391 | Christian Restoration Services | Counselor | 7157 Commerce Circle W, Fridley, MN 55432 | 2011-10-07 |
| Find all providers in zip 55432 | ||||
| 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 |
|---|---|---|---|---|
| 1972554384 | David P Kraker | Orthopaedic Surgery | 8232 Highway 65 Ne, Spring Lake Park, MN 55432-2095 | 2006-05-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780863316 | John G. Stark M.d.p.a. | Orthopaedic Surgery | 825 Nicollet Mall Ste 715, Minneapolis, MN 55402-2613 | 2007-10-31 |
| 1740220466 | Thomas Vincent Rieser | Orthopaedic Surgery | 1950 Curve Crest Blvd W Ste 130, Stillwater, MN 55082-6062 | 2006-06-08 |
| 1598712788 | Glenn Robin Buttermann | Orthopaedic Surgery | 1835 County Road C W Ste 150, Roseville, MN 55113-1343 | 2006-05-31 |
| 1649220849 | Garry M Banks | Orthopaedic Surgery | 8290 University Ave Ne Ste 200, Fridley, MN 55432-1876 | 2006-05-11 |
| 1114989555 | Sunny S Kim | Orthopaedic Surgery | 1601 Highway 13 E Ste 211, Burnsville, MN 55337-5105 | 2006-04-03 |
| 1023001815 | Ilbnc, P.a. | Orthopaedic Surgery | 3001 Metro Dr, Suite 330, Bloomington, MN 55425-4506 | 2005-08-26 |
| 1881690493 | Daniel W Hanson | Orthopaedic Surgery | 2780 Snelling Ave N Ste 310, Roseville, MN 55113-7125 | 2005-06-28 |
| 1336765098 | Inspired Spine Surgcenter LLC | Orthopaedic Surgery | 1601 Highway 13 E Ste 211, Burnsville, MN 55337-5105 | 2020-06-18 |
| 1427686575 | Sunny S. Kim, Md Pa | Orthopaedic Surgery | 1601 Highway 13 E Ste 211, Burnsville, MN 55337-5105 | 2020-04-01 |
| 1205481041 | Sunny S. Kim, Md Pa | Orthopaedic Surgery | 1601 Highway 13 E Ste 211, Burnsville, MN 55337-5105 | 2019-08-08 |
| Find all providers with the same taxonomy | ||||
| City | SPRING LAKE PARK |
| Zip Code | 55432 |
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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.