Provider Demographics
NPI:1477179729
Name:SPINE INJURY AND REGENERATIVE ORTHOPAEDICS SIRO LLC
Entity Type:Organization
Organization Name:SPINE INJURY AND REGENERATIVE ORTHOPAEDICS SIRO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PARAS
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:913-489-9070
Mailing Address - Street 1:7127 W 95TH ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66212-2245
Mailing Address - Country:US
Mailing Address - Phone:913-489-9070
Mailing Address - Fax:913-489-9080
Practice Address - Street 1:7127 W 95TH ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66212-2245
Practice Address - Country:US
Practice Address - Phone:913-489-9070
Practice Address - Fax:913-489-9080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-23
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty