JAMES H EXTINE (NPI# 1609803477) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609803477 |
| Entity Type | Individual |
| Full Name | JAMES H EXTINE |
| Credential | DO |
| Practice Address |
2516 Broadmoor Blvd Monroe LA 71201-2988 |
| Mailing Address |
130 Desiard St Ste 355 Monroe LA 71201-7363 |
| Practice Telephone | 3188074746 |
| Practice Fax Number | 3188126034 |
| Mailing Telephone | 3188077875 |
| Mailing Fax Number | 3188126603 |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2019-06-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207X00000X | Orthopaedic Surgery | 307337 | LA | Allopathic & Osteopathic Physicians |
| N | 207X00000X | Orthopaedic Surgery | 071493 | GA | Allopathic & Osteopathic Physicians |
| N | 207X00000X | Orthopaedic Surgery | DO0000001192 | TN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | PALMETTO GBA | 1170140002 | 01 |
| LA | 2462750 | 05 | |
| TN | OWCP | 373856800 | 01 |
| TN | 3304909 | 05 | |
| TN | BLUE CROSS BLUE SHIELD TN | 3139316 | 01 |
| TN | CIGNA | 1120944 | 01 |
| TN | RAILROAD MEDICARE | 200037893 | 01 |
| TN | AMERICHOICE TENNCARE | TN0139 | 01 |
| Street Address |
2516 BROADMOOR BLVD |
| City | MONROE |
| State | LA |
| Zip Code | 71201-2988 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710974969 | Kami Worley Wiedeman | Nurse Practitioner | 2516 Broadmoor Blvd, Monroe, LA 71201-2988 | 2005-10-03 |
| 1609366053 | Affinity Health Group LLC | Clinic/Center | 2516 Broadmoor Blvd, Monroe, LA 71201-2988 | 2018-05-11 |
| 1386007672 | Joy Renee Huggins | Registered Nurse | 2516 Broadmoor Blvd, Monroe, LA 71201-2988 | 2016-04-04 |
| 1588040703 | Emily Willard | Nurse Practitioner | 2516 Broadmoor Blvd, Monroe, LA 71201-2988 | 2015-08-11 |
| 1871975847 | Amber Kelly | Nurse Practitioner | 2516 Broadmoor Blvd, Monroe, LA 71201-2988 | 2015-06-25 |
| 1861879249 | Affinity Health Group, LLC | Orthopaedic Surgery | 2516 Broadmoor Blvd, Monroe, LA 71201-2988 | 2015-05-05 |
| 1629469812 | Affinity Health Group, LLC | Surgery | 2516 Broadmoor Blvd, Monroe, LA 71201-2988 | 2015-02-10 |
| 1982002911 | Affinity Health Group, LLC | Internal Medicine | 2516 Broadmoor Blvd, Monroe, LA 71201-2988 | 2014-12-08 |
| 1275942757 | Affinity Health Group LLC | Internal Medicine | 2516 Broadmoor Blvd, Monroe, LA 71201-2988 | 2014-08-08 |
| 1750793378 | Affinity Health Group, LLC | Otolaryngology | 2516 Broadmoor Blvd, Monroe, LA 71201-2988 | 2014-06-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043831035 | Tammy Price | Social Worker | 414 Pine Street, Monroe, LA 71201 | 2020-04-30 |
| 1932749116 | Emmanuel Brown Jr. | Case Manager/Care Coordinator | 2808 Evangeline Street, Monroe, LA 71201 | 2020-01-15 |
| 1063050961 | James J Gregory | Social Worker | 4800 S Grand, Monroe, LA 71201 | 2019-12-11 |
| 1285271221 | William Fairley | Non-emergency Medical Transport (VAN) | 1002 N. 7th St., Apt. 4, Monroe, LA 71201 | 2019-12-10 |
| 1619431715 | Guidance Medical Transportation LLC | Non-emergency Medical Transport (VAN) | 1204 Stubbs Ave. Suite B, Monroe, LA 71201 | 2019-01-23 |
| 1184193286 | Marnesha Davis | Assistant Behavior Analyst | 500 N. 21st Street, Monroe, LA 71201 | 2018-11-19 |
| 1912476482 | Gbc Hope | Residential Treatment Facility, Emotionally Disturbed Children | 311 South 1st Street, Monroe, LA 71201 | 2018-11-14 |
| 1124502505 | Orthopaedic Clinic of Monroe | Non-Pharmacy Dispensing Site | 1501 Louisville Ave., Monroe, LA 71201 | 2018-09-20 |
| 1699266643 | Melissa Anne De La O | Audiologist | 2516 Broadmoor Blvd # 1b, Monroe, LA 71201 | 2018-05-25 |
| 1588153738 | Essential Family Medicine, LLC | Nurse Practitioner | 2014 Tower Dr. Ste A, Monroe, LA 71201 | 2018-05-03 |
| Find all providers in zip 71201 | ||||
| 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 |
|---|---|---|---|---|
| 1154714475 | Athens Orthopedic Clinic, Pa | Orthopaedic Surgery | 2151 W Spring St Ste 140, Monroe, GA 30655-3115 | 2015-03-11 |
| 1730519935 | Joseph John King II | Orthopaedic Surgery | 1310 New Salem Rd, Monroe, NC 28110-9696 | 2013-11-25 |
| 1558529438 | Larry Martin Jr. | Orthopaedic Surgery | 2000 Wellness Blvd Ste 140, Monroe, NC 28110-3354 | 2008-05-28 |
| 1376592261 | David Christopher Harkins | Orthopaedic Surgery | 2151b W Spring St Ste 140, Monroe, GA 30655-3115 | 2006-05-08 |
| 1952385809 | Sandra M King | Orthopaedic Surgery | 701 E Roosevelt Blvd, Bldg 600, Monroe, NC 28112-5170 | 2005-12-05 |
| 1144203209 | John Bernard Meade | Orthopaedic Surgery | 808 Circle Dr, Monroe, NC 28112-3800 | 2005-11-22 |
| 1619950771 | Jeffrey Morris Daily | Orthopaedic Surgery | 703 Comfort Ln, Monroe, NC 28112-5684 | 2005-11-22 |
| 1740287291 | Kenneth Joseph Mcnamee | Orthopaedic Surgery | 214 E Elm Ave, Suite 200, Monroe, MI 48162-2600 | 2005-06-30 |
| 1679577621 | Anthony Emmanuel Melonakos | Orthopaedic Surgery | 1420 N Monroe St, Monroe, MI 48162-4211 | 2005-06-08 |
| 1710453253 | Affinity Health Gorup, LLC | Orthopaedic Surgery | 920 Oliver Rd, Waiting Area L, Monroe, LA 71201-5702 | 2018-10-23 |
| Find all providers in MONROE | ||||
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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.