JAX SPINE & PAIN CENTERS

Q: What is Jacksonville Spine Center PA's NPI number?

The NPI number for Jacksonville Spine Center PA is 1912560798. It was assigned to this organization in the NPPES registry on April 17, 2019. The provider is doing business as Jax Spine & Pain Centers.

Q: What is Jacksonville Spine Center PA's specialty?

The primary specialty registered for this NPI is Pain Medicine, specializing in Interventional Pain Medicine, with taxonomy code 208VP0014X.

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About Jax Spine & Pain Centers NPPES

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

JAX SPINE & PAIN CENTERS (NPI 1912560798) is a healthcare organization registered as an interventional pain medicine in Fleming Island, Florida and active in the NPI registry since April 2019. The organization lists Alicia M Groth, Credentialing Specialist, as its authorized official.

NPPES Registry Identity

NPI1912560798

Entity TypeOrganization

Primary Taxonomy208VP0014X

Legal Business NameJACKSONVILLE SPINE CENTER PA

Location Address2349 VILLAGE SQUARE PKWY STE 107Fleming Island, FL 32003-4319

Mailing Address5191 First Coast Tech Pkwy, 3rd FloorJacksonville, FL 32224 · (904) 223-3321 · Fax (904) 223-2169

Phone(904) 223-3321

Fax(904) 223-2169

Organization SubpartNo

Authorized OfficialAlicia M GrothCredentialing Specialist · (904) 223-3321

Enumeration DateApril 17, 2019

Last NPPES UpdateSeptember 23, 20223 updates tracked since enumeration

NPPES CertifiedSeptember 20, 2022

✔ NPI 1912560798 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPain Medicine · Interventional Pain MedicineAllopathic & Osteopathic Physicians

Taxonomy Code208VP0014X

Definition

Interventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment.

2349 VILLAGE SQUARE PKWY STE 107, Fleming Island, FL 32003

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Other Names 1

Doing Business AsJax Spine & Pain Centers

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 Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company).Insurance ›

Medical Equipment Supplier Medicare DMEPOS 2

Medicare supplier enrollment and the product categories Jax Spine & Pain Centers carries, from the Medicare DMEPOS supplier directory.

DMEPOS supplier · Fleming Island, FLOperated by Jacksonville Spine Center PA

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Accepts Medicare assignment

Jax Spine & Pain Centers agrees to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients are not billed beyond the standard deductible and coinsurance.

PTAN (Medicare Supplier Number)20593667

Medicare Participant SinceJanuary 1, 2004

Supplier Location2349 Village Square Pkwy Ste 107Fleming Island, FL 32003

Phone(904) 223-3321

Provider TypeAll Other Supplies (ie, Drug Stores, Etc.) · Physician – Anesthesiology

Medicare Product Categories

Orthoses: Custom Fabricated

Custom met pads, Custom heel pads, Custom heel spur pads

Orthoses: Off-The-Shelf

Met pads, Heel pads, Heel spur pads

Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

Other Providers at the Same Location NPPES 5

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

TIFFANY N ROGERS APRN

Nurse Practitioner (Family)