SPINE TRANSFORMATION LLC
NPI 1215192265
Orthopaedic Surgery - Orthopaedic Surgery of the Spine in Ardmore, OK

Q: What is Spine Transformation LLC's NPI number?

The NPI number for Spine Transformation LLC is 1215192265. It was assigned to this organization in the NPPES registry on July 18, 2008.

Q: What is Spine Transformation LLC's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery, specializing in Orthopaedic Surgery of the Spine, with taxonomy code 207XS0117X.

Active since July 18, 2008

915 10TH AVE NW, ARDMORE, OK 73401(580) 223-7200(580) 223-7207 Get Directions Write a Review

NPPES record last updated: November 10, 2010. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Spine Transformation Llc NPPES

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

SPINE TRANSFORMATION LLC (NPI 1215192265) is a healthcare organization registered as an orthopaedic surgery of the spine in Ardmore, Oklahoma and active in the NPI registry since July 2008. The organization lists Dereck Aaron Peery, President/owner, as its authorized official.

NPPES Registry Identity

NPI1215192265

Entity TypeOrganization

Primary Taxonomy207XS0117X

Legal Business NameSPINE TRANSFORMATION LLC

Location Address915 10TH AVE NWArdmore, OK 73401-4025

Mailing Address915 10th Ave NwArdmore, OK 73401-4025 · (580) 223-7200 · Fax (580) 223-7207

Phone(580) 223-7200

Fax(580) 223-7207

Organization SubpartNo

Authorized OfficialDereck Aaron PeeryPresident/owner · (580) 223-7200

Enumeration DateJuly 18, 2008

Last NPPES UpdateNovember 10, 2010

✔ NPI 1215192265 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic Surgery · Orthopaedic Surgery of the SpineAllopathic & Osteopathic Physicians

Taxonomy Code207XS0117X

License✔ Licensed in OK · 4546

Definition

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.

915 10TH AVE NW, Ardmore, OK 73401

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Other Identifiers 3

Medicaid200204540AOK

Medicare NSC6283810001OK

Medicare PINOKB5216

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 7

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

DR. DERECK A. PEERY D.O.

Orthopaedic Surgery (Orthopaedic Surgery of the Spine)