MID-STATE ORTHOPAEDIC & SPORTS MEDICINE CENTER LLC (NPI# 1104890052) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104890052 |
| Entity Type | Organization |
| Organization Name | MID-STATE ORTHOPAEDIC & SPORTS MEDICINE CENTER LLC |
| Other Organization Name | MID-STATE ORTHOPAEDIC & SPORTS MEDICINE CENTER INC |
| Practice Address |
3444 Masonic Drive Alexandria LA 71301-3615 |
| Practice Telephone | 3184739556 |
| Practice Fax Number | 3184418310 |
| Mailing Telephone | 3184739556 |
| Mailing Fax Number | 3184418310 |
| Enumeration Date | 2006-02-16 |
| Last Update Date | 2015-03-23 |
| Authorized Official Name | MR. MARK A DODSON (PRESIDENT) |
| Authorized Official Telephone | 3184739556 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 213E00000X | Podiatrist | Podiatric Medicine & Surgery Service Providers | ||
| Y | 207X00000X | Orthopaedic Surgery | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | RAILROAD MEDICARE PALMETT | CD7720 | 01 |
| LA | 1946320 | 05 | |
| LA | MEDICARE DME GROUP # | 0570570001 | 01 |
| Other Name | Type Code |
|---|---|
| Mid-State Orthopaedic & Sports Medicine Center Inc | Former Legal Business Name - Organization |
| Street Address |
3444 MASONIC DRIVE |
| City | ALEXANDRIA |
| State | LA |
| Zip Code | 71301-3615 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396093837 | Sarah Jean Griffin | Physician Assistant | 3444 Masonic Drive, Alexandria, LA 71301 | 2012-08-15 |
| 1245460013 | Timmothy Ryan Randell | Orthopaedic Surgery | 3444 Masonic Drive, Alexandria, LA 71301 | 2009-07-15 |
| 1437169992 | Stacy Holston Zeller | Family Medicine | 3444 Masonic Drive, Alexandria, LA 71301 | 2006-08-08 |
| 1508889312 | Mark A Carbo | Physician Assistant | 3444 Masonic Drive, Alexandria, LA 71301 | 2006-07-25 |
| 1114940087 | Charles M Johnson Jr. | Physician Assistant | 3444 Masonic Drive, Alexandria, LA 71301 | 2006-07-25 |
| 1104849009 | Jeffrey L Garrison | Orthopaedic Surgery | 3444 Masonic Drive, Alexandria, LA 71301 | 2006-07-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689217457 | Geaux Trans Transportation | Non-emergency Medical Transport (VAN) | 3101 Quail Court Apt A, Alexanadria, LA 71301 | 2019-10-23 |
| 1679115497 | Emily Belgard | Case Manager/Care Coordinator | 1715 Ashley Avenue, Suite A, Alexandria, LA 71301 | 2019-10-14 |
| 1316591878 | Leronisha Murphey | Technician | 1300 Jackson Street, Alexandria, LA 71301 | 2019-08-01 |
| 1144782996 | Ashley Billings | Student in an Organized Health Care Education/Training Program | 403 E 3rd Street Ste 3h, Family Medicine, Alexandria, LA 71301 | 2019-04-02 |
| 1740753110 | Maranda Trotti Voorhies | Nurse Practitioner | 501 Medical Center Dr. Suite 200, Alexandria, LA 71301 | 2019-01-08 |
| 1326565359 | Sheryl Ann Truman | Registered Nurse | 3224 Madonna Drive, Alexandria, LA 71301 | 2017-08-30 |
| 1770001620 | Casey Holts | Counselor | 5760 Goodland Trace, Alexandria, LA 71301 | 2017-08-30 |
| 1942735956 | Transforming Lives, Inc. | Community/Behavioral Health | 1428 Peterman Dr Ste A, Alexandria, LA 71301 | 2017-04-27 |
| 1790216703 | Johnnetta Rutledge | Counselor | 39 Kent Ave, Alexandria, LA 71301 | 2017-03-22 |
| 1104367788 | Clarissa Dione Pugh | Counselor | 23 Tennessee Ave, Alexandria, LA 71301 | 2017-03-15 |
| Find all providers in zip 71301 | ||||
| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730636861 | Mid State Orthopaedics & Sports Medicine Center LLC | Orthopaedic Surgery | 224 Pecan Park, Suite F, Alexandria, LA 71302 | 2016-09-07 |
| 1437570975 | Joel Gregory Goldman | Orthopaedic Surgery | 2047 Blunt Lane, Alexandria, VA 22303 | 2013-12-31 |
| 1851658603 | Washington Orthopaedic Center LLC | Orthopaedic Surgery | 417 N Washington St, Alexandria, VA 22314-2311 | 2012-04-18 |
| 1306112743 | Daniel Philip Deasis | Orthopaedic Surgery | 201 4th St Ste 1d, Alexandria, LA 71301 | 2012-03-29 |
| 1235404252 | Cedric Warren Lowrey | Orthopaedic Surgery | 4506 Wellington Blvd, Alexandria, LA 71303-2513 | 2012-03-09 |
| 1649436254 | Craig Joseph Mcasey | Orthopaedic Surgery | 2501 Parkers Ln Ste 200, Alexandria, VA 22306-3209 | 2008-08-03 |
| 1013119007 | Terence James Kennedy | Orthopaedic Surgery | 733 W Latoka Dr Sw, Alexandria, MN 56308-9376 | 2007-06-03 |
| 1114063435 | Brian O Stephens | Orthopaedic Surgery | 106 N Lee St Ste 200, Alexandria, VA 22314 | 2007-01-30 |
| 1386667350 | Orthovirginia, Inc | Orthopaedic Surgery | 2805 Duke St, Alexandria, VA 22314-4512 | 2006-07-25 |
| 1821062670 | Michael Elden Brunet | Orthopaedic Surgery | 3351 Masonic Dr, Alexandria, LA 71301-3842 | 2006-02-16 |
| Find all providers in ALEXANDRIA | ||||
| City | ALEXANDRIA |
| Zip Code | 71301 |
Please comment or provide details below to improve the information on MID-STATE ORTHOPAEDIC & SPORTS MEDICINE CENTER LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.