1. Home
  2. Directory
  3. North Carolina
  4. Charlotte
  5. Physical Medicine Rehabilitation
  6. NPI Profile

ADVANCED SPORTS & SPINE, PLLC
NPI 1629422738
Physical Medicine & Rehabilitation - Pain Medicine in Charlotte, NC

Active since April 15, 2016CLIA 34D2350142 · Waiver
8035 PROVIDENCE RD, #340, CHARLOTTE, NC 28277(704) 542-3988 Get Directions Write a Review

NPPES record last updated: April 12, 2018. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Apr 12, 2018, Mar 20, 2018 (2 updates tracked since 2018).

About Advanced Sports & Spine, Pllc NPPES

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

ADVANCED SPORTS & SPINE, PLLC (NPI 1629422738) is a healthcare organization registered as a pain medicine in Charlotte, North Carolina and active in the NPI registry since April 2016. The organization holds a CLIA Waiver certificate valid through September 2, 2028 and lists Usman Fayyaz Ahmad, Sole Member, as its authorized official.

NPPES Registry Identity

NPI1629422738
Entity TypeOrganization
Primary Taxonomy2081P2900X
Legal Business NameADVANCED SPORTS & SPINE, PLLC
Location Address8035 PROVIDENCE RD, #340Charlotte, NC 28277-9716
Mailing Address8035 Providence Rd Ste 340Charlotte, NC 28277-9717 · (704) 542-3988 · Fax (704) 542-3912
Phone(704) 542-3988
Organization SubpartNo
Authorized OfficialUsman Fayyaz AhmadSole Member · (704) 542-3988
Enumeration DateApril 15, 2016
Last NPPES UpdateApril 12, 20182 updates tracked since enumeration
✔ NPI 1629422738 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysical Medicine & Rehabilitation · Pain MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2081P2900X
License✔ Licensed in NC · 2015-01401
Definition
A physician who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists.
8035 PROVIDENCE RD, Charlotte, NC 28277
Open in Google Maps ↗

Other Identifiers 1

Medicaid1629422738NC

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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of NC, BlueCross BlueShield of South Carolina.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Advanced Sports & Spine, Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Advanced Sports & Spine, PLLC, which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.

Clinicians, nearest first (2)

David Ciaccia, DO
Physical Medicine and Rehabilitation
NPI 1316380207
8035 PROVIDENCE RD STE 340
Charlotte, NC 28277
(704) 542-3988
✔ PECOS✔ Accepts MedicareSame address
Usman Ahmad, D.O.
Pain Management
NPI 1558676692
8035 PROVIDENCE RD SUITE 340
Charlotte, NC 28277
(704) 542-3988
✔ PECOSSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 34D2350142

Advanced Sports & Spine · Stony Point, NC
Active · expires Sep 2, 2028
CLIA Number34D2350142
Laboratory TypePhysician Office
Certificate Effective DateSeptember 3, 2026
Certificate Expiration DateSeptember 2, 2028
Laboratory DirectorUsman F. Ahmad
Laboratory Phone(704) 542-3988
Laboratory LocationAdvanced Sports & Spine9920 Kincey Ave Suite 200, Stony Point, NC 28678
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Advanced Sports & Spine, PLLC's NPI number?

The NPI number for Advanced Sports & Spine, PLLC is 1629422738. It was assigned to this organization in the NPPES registry on April 15, 2016.

Where is Advanced Sports & Spine, PLLC located?

Advanced Sports & Spine, PLLC is located at 8035 Providence Rd #340, Charlotte, NC 28277. The listed phone number is (704) 542-3988.

What is Advanced Sports & Spine, PLLC's specialty?

The primary specialty registered for this NPI is Physical Medicine & Rehabilitation, specializing in Pain Medicine, with taxonomy code 2081P2900X.

Is Advanced Sports & Spine, PLLC enrolled in Medicare?

Yes. Advanced Sports & Spine, PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Advanced Sports & Spine, PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Advanced Sports & Spine, PLLC, in Pain Management and Physical Medicine and Rehabilitation. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Advanced Sports & Spine, PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 34D2350142) is associated with this NPI, valid through September 2, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Advanced Sports & Spine, PLLC accept?

Health plans from Blue Cross and Blue Shield of NC and BlueCross BlueShield of South Carolina list Advanced Sports & Spine, PLLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Advanced Sports & Spine, PLLC was last updated on April 12, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years 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.