Southern Spine & Rehab, PLLC
NPI 1083254734 · Clinic/Center · Marion, IL
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Southern Spine & Rehab, PLLC is a Clinic/Center organization in Marion, IL (NPI 1083254734).
Provider details
- NPI number
- 1083254734
- Entity type
- Organization
- Primary specialty
- Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Kolten Pedigo, Owner(618) 772-2999
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
6 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Additional practice locations (1)
- 1004 Enterprise DrSuite BAnna, IL 62906Phone: (618) 772-2999
Registry dates
- Enumerated
- 2020-01-10
- Last updated
- 2025-02-05
- Certified
- 2025-02-05
Frequently asked questions
- What is Southern Spine & Rehab, PLLC's NPI number?
- Southern Spine & Rehab, PLLC's National Provider Identifier (NPI) is 1083254734, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Southern Spine & Rehab, PLLC?
- Southern Spine & Rehab, PLLC is classified in the NPPES registry as Clinic/Center (Ambulatory Health Care Facilities).
- Where is Southern Spine & Rehab, PLLC located?
- Southern Spine & Rehab, PLLC's practice location on file with NPPES is 1616 W Main St Ste 200, Marion, IL 62959-1146.
- What is Southern Spine & Rehab, PLLC's phone number?
- The practice phone number listed in the NPPES registry for Southern Spine & Rehab, PLLC is (618) 772-2999.
- Does Southern Spine & Rehab, PLLC accept Medicare?
- Southern Spine & Rehab, PLLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Southern Spine & Rehab, PLLC?
- The authorized official listed on Southern Spine & Rehab, PLLC's NPPES record is Kolten Pedigo, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Southern Spine & Rehab, PLLC's NPI active?
- Yes — Southern Spine & Rehab, PLLC's NPI (1083254734) is active in the NPPES registry as of the last update on 2025-02-05.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.