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SOUTHERN SPINE & REHAB, PLLC
NPI 1083254734
Clinic/Center in Marion, IL

Active since January 10, 2020
1616 W MAIN ST STE 200, MARION, IL 62959(618) 772-2999 Get Directions Write a Review

NPPES record last updated: February 5, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Feb 5, 2025, Feb 17, 2023, Jan 10, 2020 (3 updates tracked since 2020).

About Southern Spine & Rehab, Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUTHERN SPINE & REHAB, PLLC (NPI 1083254734) is a healthcare organization registered as a clinic/center in Marion, Illinois and active in the NPI registry since January 2020. The organization maintains a secondary practice location in Anna and lists Kolten Pedigo, Owner, as its authorized official.

NPPES Registry Identity

NPI1083254734
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NameSOUTHERN SPINE & REHAB, PLLC
Location Address1616 W MAIN ST STE 200Marion, IL 62959-1146
Mailing Address1616 W Main St Ste 200Marion, IL 62959-1146
Phone(618) 772-2999
Organization SubpartNo
Authorized OfficialKolten PedigoOwner · (618) 772-2999
Enumeration DateJanuary 10, 2020
Last NPPES UpdateFebruary 5, 20253 updates tracked since enumeration
NPPES CertifiedFebruary 5, 2025
✔ NPI 1083254734 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities
Taxonomy Code261Q00000X
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
1616 W MAIN ST STE 200, Marion, IL 62959
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Secondary Practice Location 1

Location 11004 Enterprise Dr, Suite BAnna, IL 62906 · Phone (618) 772-2999

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

EMILY DICKMAN DC
Chiropractor
1616 W MAIN ST STE 200
MARION, IL 62959
Williamson County (618) 694-9797
KOLTEN PEDIGO DC
Chiropractor
1616 W MAIN ST STE 200
MARION, IL 62959
Williamson County (618) 772-2999

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Southern Spine & Rehab, PLLC's NPI number?

The NPI number for Southern Spine & Rehab, PLLC is 1083254734. It was assigned to this organization in the NPPES registry on January 10, 2020.

Where is Southern Spine & Rehab, PLLC located?

Southern Spine & Rehab, PLLC is located at 1616 W Main St Ste 200, Marion, IL 62959. The listed phone number is (618) 772-2999.

What is Southern Spine & Rehab, PLLC's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

When was this NPI record last updated?

The NPPES record for Southern Spine & Rehab, PLLC was last updated on February 5, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.