ORTHOPAEDIC CENTER OF IL (NPI# 1154300572) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154300572 |
| Entity Type | Organization |
| Organization Name | ORTHOPAEDIC CENTER OF IL |
| Practice Address |
1301 S Koke Mill Rd Springfield IL 62711-9252 |
| Mailing Address |
Po Box 9469 Springfield IL 62791-9469 |
| Practice Telephone | 2175479100 |
| Mailing Telephone | 2175479132 |
| Enumeration Date | 2006-01-13 |
| Last Update Date | 2009-11-13 |
| Authorized Official Name | LORI A ROETHEMEYER (CEO) |
| Authorized Official Telephone | 2175479100 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208100000X | Physical Medicine & Rehabilitation | Allopathic & Osteopathic Physicians | ||
| N | 213E00000X | Podiatrist | Podiatric Medicine & Surgery Service Providers | ||
| Y | 207X00000X | Orthopaedic Surgery | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | RR MEDICARE | CI5139 | 01 |
| IL | RR MEDICARE | CD2682 | 01 |
| Street Address |
1301 S KOKE MILL RD |
| City | SPRINGFIELD |
| State | IL |
| Zip Code | 62711-9252 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902892607 | D Gordon Allan | Orthopaedic Surgery | 1301 S Koke Mill Rd, Springfield, IL 62711-9252 | 2005-09-27 |
| 1558973461 | Charity E Williams | Physical Therapist | 1301 S Koke Mill Rd, Springfield, IL 62711-9252 | 2020-08-21 |
| 1811509821 | Christina Prefountain | Registered Nurse | 1301 S Koke Mill Rd, Springfield, IL 62711-9252 | 2020-08-20 |
| 1467061408 | Daniel S Rebeck | Physical Therapist | 1301 S Koke Mill Rd, Springfield, IL 62711-9252 | 2020-07-27 |
| 1245850767 | Zachary M Barnett | Physician Assistant | 1301 S Koke Mill Rd, Springfield, IL 62711-9252 | 2020-04-24 |
| 1356961908 | Jessica Brough | Physician Assistant | 1301 S Koke Mill Rd, Springfield, IL 62711-9252 | 2020-04-23 |
| 1013536093 | Molly L Morgan | Physical Therapist | 1301 S Koke Mill Rd, Springfield, IL 62711-9252 | 2020-04-10 |
| 1326670183 | Jeffery R Chambers | Nurse Practitioner | 1301 S Koke Mill Rd, Springfield, IL 62711-9252 | 2020-02-10 |
| 1225677396 | Carrie F Thornton | Registered Nurse | 1301 S Koke Mill Rd, Springfield, IL 62711-9252 | 2020-01-06 |
| 1730724972 | Lindsay Breanne Dixon | Nurse Practitioner | 1301 S Koke Mill Rd, Springfield, IL 62711-9252 | 2019-11-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578057220 | Merissa Pryor | Social Worker | 4200 Conestoga Drive, Mbn 120, Springfield, IL 62711 | 2018-06-17 |
| 1255884623 | Dental Professionals of Illinois, P.C. | Dentist | 2740 Prairie Crossing Drive, Springfield, IL 62711 | 2016-08-02 |
| 1841682424 | Americare At Centennial Pointe Assisted Living LLC | Assisted Living Facility | 3440 Hedley Road, Springfield, IL 62711 | 2015-02-19 |
| 1306249248 | Schon Dental, LLC | Dentist | 2809 Mansion Road Suite D, Springfield, IL 62711 | 2014-10-07 |
| 1891105490 | John Weiss | Pharmacist | 4200 Conestoga Drive, Springfield, IL 62711 | 2014-05-05 |
| 1720350689 | Victor Harold Lary | Family Medicine | 3251 Spaulding Orchard Road, Springfield, IL 62711 | 2012-02-07 |
| 1902181795 | Amanda Rose Davis | Pharmacist | 2500 Koke Mill Rd, Springfield, IL 62711 | 2011-10-12 |
| 1316233703 | Karen Zerkle | Dentist | 2809 Mansion Rd, Suite D, Springfield, IL 62711 | 2011-06-23 |
| 1255520557 | Link Chiropractic LLC | Chiropractor | 7012 Kingsmill Ct, Springfield, IL 62711 | 2007-10-23 |
| 1669688230 | Victoria Lynn Driskill | Dentist | 4701 W. Wabash Ave, Springfield, IL 62711 | 2007-05-14 |
| Find all providers in zip 62711 | ||||
| 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 |
|---|---|---|---|---|
| 1104440049 | Elliot M Johns | Orthopaedic Surgery | 301 N 8th St Ste 3a158, Springfield, IL 62701-1085 | 2020-06-06 |
| 1740804764 | David Alan Forgas | Orthopaedic Surgery | 901 N 1st St # D252, Springfield, IL 62702-3759 | 2020-06-05 |
| 1063849719 | Effingham Hospital, Inc. | Orthopaedic Surgery | 459 Highway 119 S Ste A, Springfield, GA 31329-3021 | 2013-09-26 |
| 1851646566 | Kenneth David Illingworth | Orthopaedic Surgery | 301 N 8th St Pav 3a158, Springfield, IL 62794 | 2012-07-18 |
| 1760792329 | Lasante Inc | Orthopaedic Surgery | 4936 Laverna Road, Springfield, IL 62707-9797 | 2010-10-18 |
| 1902134638 | Optim Orthopedics, LLC | Orthopaedic Surgery | 459 Highway 119 South, Springfield, GA 31329 | 2009-11-18 |
| 1861630113 | Acustep Diabetic Foot Center, LLC | Orthopaedic Surgery | 2139 W Republic Rd, Springfield, MO 65807-5705 | 2009-01-24 |
| 1902066491 | Charles Joseph Ash | Orthopaedic Surgery | 3433 I S Campbell, Springfield, MO 65807 | 2008-06-10 |
| 1366616849 | Jennie Garver | Orthopaedic Surgery | 300 Birnie Ave Ste 301, Springfield, MA 01107 | 2008-04-16 |
| 1841487733 | Maplegate Rehab Inc. Dba Medical Associates | Orthopaedic Surgery | 181 State St, Springfield, MA 01103-1719 | 2007-09-25 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 62711 |
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| 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.