ADVANCED SPINE AND REHAB CENTER PC NPI 1386785293

NPI Information

NPI: 1386785293
Provider Name: ADVANCED SPINE AND REHAB CENTER PC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 16D2022914

Address:
4205 GLASS RD NE
CEDAR RAPIDS, IA
ZIP 52402
Phone: (319) 294-0094
Get Directions

ADVANCED SPINE AND REHAB CENTER PC is a family medicine in Cedar Rapids, IA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. ADVANCED SPINE AND REHAB CENTER PC NPI is 1386785293. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

4205 GLASS RD NE
CEDAR RAPIDS, IA
ZIP 52402-514
Phone: (319) 294-0094
Fax: (319) 294-0095

The provider's authorized official is Jeffrey Alan Mitchell .
The authorized official title is President and has the following contact phone number (319) 981-2292.

The CLIA number assigned to this NPI record is 16D2022914 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/12/2007 and was last updated on 2/2/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	License Number	License State	Primary
1	207R00000X	Internal Medicine	27216	IOWA	No
2	111N00000X	Chiropractor	6916	IOWA	No
3	363L00000X	Nurse Practitioner	110073	IOWA	No
4	332B00000X	Durable Medical Equipment & Medical Supplies		IOWA	No
5	207Q00000X	Family Medicine			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	I19185	MEDICARE PIN	IOWA
2	6028990001	MEDICARE NSC	IOWA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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