ORTHOPEDIC AND SPORTS MEDICINE CENTER OF NORTHERN INDIANA, INC (NPI# 1295397735) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295397735 |
| Entity Type | Organization |
| Organization Name | ORTHOPEDIC AND SPORTS MEDICINE CENTER OF NORTHERN INDIANA, INC |
| Practice Address |
200 E Jackson Blvd Ste 130 Elkhart IN 46516-3513 |
| Mailing Address |
2310 California Rd Ste A Elkhart IN 46514-1228 |
| Practice Telephone | 5742640791 |
| Practice Fax Number | 5742645183 |
| Mailing Telephone | 5742061401 |
| Mailing Fax Number | 5742625183 |
| Enumeration Date | 2019-07-05 |
| Last Update Date | 2019-07-05 |
| Authorized Official Name | ROBIN S. MCLAUGHLIN (CAO) |
| Authorized Official Telephone | 5749704455 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 335E00000X | Prosthetic/Orthotic Supplier | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 300026304 | 05 |
| Other Name | Type Code |
|---|---|
| Orthopedic & Sports Medicine Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710085253 | Orthopedic and Sports Medicine Center of Northern Indiana, Inc | Anesthesiology | 2310 California Rd Ste A, Elkhart, IN 46514-1228 | 2006-09-20 |
| Street Address |
200 E JACKSON BLVD STE 130 |
| City | ELKHART |
| State | IN |
| Zip Code | 46516-3513 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558974675 | Courtney Rae Lawson | Nurse Practitioner | 1178 Fremont Ct., Elkhart, IN 46516 | 2020-08-28 |
| 1932690955 | Lisa Cooper | Counselor | 529 S 2nd St, Elkhart, IN 46516 | 2018-05-24 |
| 1780183558 | Evolve Chiropractic, LLC | Chiropractor | 5301 Beck Dr. Suite 3, Elkhart, IN 46516 | 2018-02-07 |
| 1790215168 | Cutting Edge Integrative Pain Centers LLC | Internal Medicine | 242 Waterfall Dr Ste B, Elkhart, IN 46516 | 2017-06-18 |
| 1831448745 | Planned Parenthood of Indiana Elkhart | Clinic/Center | 505 S. Third St., Suite 160, Elkhart, IN 46516 | 2012-09-06 |
| 1588920128 | Physical Therapy Professionals PC | Clinic/Center | 932 Parkway Ave, Ste. B, Elkhart, IN 46516 | 2012-04-09 |
| 1821369091 | Marek Serwatka | Physical Therapist | 932 Parkway Ave Ste B, Elkhart, IN 46516 | 2012-01-19 |
| 1538459904 | Rose M. Mwania | Nurse Anesthetist, Certified Registered | 1004 Parkway Ave Ste A, Elkhart, IN 46516 | 2011-04-19 |
| 1487894838 | Jack Alan Turnock | Dentist | 330 West Lexington Ave, Suite 201, Elkhart, IN 46516 | 2009-02-25 |
| 1225207285 | Wal-mart Stores East, Lp | Eyewear Supplier (Equipment, not the service) | 30830 Old Us 33, Elkhart, IN 46516 | 2008-02-25 |
| Find all providers in zip 46516 | ||||
| Taxonomy Code | 335E00000X |
| Grouping | Suppliers |
| Classification | Prosthetic/Orthotic Supplier |
| An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition. |
| Notes: Source: American Board for Certification in Orthotics, Prosthetics, and Pedorthics, Inc. [7/1/2010: modified, 7/1/2013: modified] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003326174 | Bionic Prosthetics and Orthotics Group LLC | Prosthetic/Orthotic Supplier | 3130a Windsor Ct, Elkhart, IN 46514-5556 | 2017-10-03 |
| 1326550351 | Ascendant Orthopedic Alliance, LLC | Prosthetic/Orthotic Supplier | 2310 California Rd Ste A, Elkhart, IN 46514-1228 | 2017-10-31 |
| 1043425564 | Orthopedic and Sports Medicine Center of Northern Indiana, Inc. | Prosthetic/Orthotic Supplier | 2310 California Rd Ste A, Elkhart, IN 46514-1228 | 2007-05-10 |
| 1205041720 | Asc Surgical Ventures, LLC | Prosthetic/Orthotic Supplier | 2310 California Rd Ste B, Elkhart, IN 46514-1228 | 2007-05-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639781081 | Kenney Orthopedics Indianapolis, LLC | Prosthetic/Orthotic Supplier | 1801 N Senate Blvd Ste 420, Indianapolis, IN 46202-1228 | 2020-08-18 |
| 1982220109 | Bionic Prosthetics and Orthotics Group LLC | Prosthetic/Orthotic Supplier | 3647 Clifty Dr, Madison, IN 47250-1649 | 2020-06-23 |
| 1154941557 | Radiance Renewed | Prosthetic/Orthotic Supplier | 9445 Indianapolis Blvd Ste 1042, Highland, IN 46322-2648 | 2020-04-26 |
| 1710465166 | Cranial Technologies Inc | Prosthetic/Orthotic Supplier | 10603 N Meridian St Ste 120, Indianapolis, IN 46290-1055 | 2018-07-29 |
| 1285135913 | Excel Orthotics and Prosthetics LLC | Prosthetic/Orthotic Supplier | 3200 Sycamore Ct Ste 2b, Columbus, IN 47203-1552 | 2018-02-27 |
| 1285144352 | Bionic Prosthetics and Orthotics Group LLC | Prosthetic/Orthotic Supplier | 1101 Glendale Blvd Ste 105, Valparaiso, IN 46383-3769 | 2017-10-03 |
| 1669904579 | Jordan Poynter | Prosthetic/Orthotic Supplier | 3708 S Lafountain St, Kokomo, IN 46902-3805 | 2017-03-30 |
| 1184156101 | Shawn Dee Brown | Prosthetic/Orthotic Supplier | 2410 N Glendale Dr Ste C, Fort Wayne, IN 46804-8909 | 2017-03-29 |
| 1346771029 | Stride Prosthetics LLC | Prosthetic/Orthotic Supplier | 2498 Perry Crossing Way Ste 260, Plainfield, IN 46168-5520 | 2017-03-23 |
| 1598215857 | Hafeezah Carter | Prosthetic/Orthotic Supplier | 2810 Maplecrest Rd, Fort Wayne, IN 46815-7016 | 2016-10-11 |
| Find all providers with the same taxonomy | ||||
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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.