MID STATE ORTHOPAEDIC & SPORTS MEDICINE CENTER LLC (NPI# 1093262123) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093262123 |
| Entity Type | Organization |
| Organization Name | MID STATE ORTHOPAEDIC & SPORTS MEDICINE CENTER LLC |
| Practice Address |
429 Rocky Bayou Drive Pineville LA 71360 |
| Mailing Address |
3444 Masonic Drive Alexandria LA 71301 |
| Practice Telephone | 3184739556 |
| Practice Fax Number | 3184846032 |
| Mailing Telephone | 3184739556 |
| Mailing Fax Number | 3184846032 |
| Enumeration Date | 2016-09-07 |
| Last Update Date | 2020-07-20 |
| Authorized Official Name | MARK DODSON (BILLING MANAGER) |
| Authorized Official Telephone | 3184739556 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | Y |
| Parent Organization Name | MIDSTATE ORTHOPAEDIC & SPORTS CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207X00000X | Orthopaedic Surgery | 9317843 | LA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | RAILROAD MEDICARE | CD7720 | 01 |
| LA | 1946320 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205385796 | Mid State Orthopaedic & Sports Medicine Center LLC | Orthopaedic Surgery | 601 W Lafayette St, Winnfield, LA 71483-3451 | 2016-09-26 |
| 1609320506 | Mid State Orthopaedic & Sports Medicine Center LLC | Physical Medicine & Rehabilitation | 155 Ninth St, Ste A, Jena, LA 71342-3900 | 2016-08-09 |
| 1447707583 | Mid State Orthopaedic & Sports Medicine Center LLC | Orthopaedic Surgery | 504 Jack Miller Road, Villeplatte, LA 70586 | 2016-09-07 |
| Street Address |
429 ROCKY BAYOU DRIVE |
| City | PINEVILLE |
| State | LA |
| Zip Code | 71360 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740887694 | Abby Lou Hinds | Occupational Therapist | 429 Rocky Bayou Drive, Pineville, LA 71360 | 2020-10-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578110789 | Reneisha Armonii Roberts | Pharmacist | 3100 La-28, Pineville, LA 71360 | 2019-08-22 |
| 1396303145 | Tina Marie Lawhorn | Nurse Practitioner | 2945 Shreveport Hwy, Pineville, LA 71360 | 2019-06-05 |
| 1942773213 | Tioga Pharmacy LLC | Pharmacy | 5101 Shreveport Hwy, Pineville, LA 71360 | 2019-01-09 |
| 1649755497 | Jessica Wooten | Nurse Practitioner | 292 Jerry Lofton Rd, Pineville, LA 71360 | 2018-09-27 |
| 1215421995 | Elizabeth Simon-clark | Counselor | Central La State Hospital Unit 6 Meadows Lane, Pineville, LA 71360 | 2018-06-18 |
| 1982116497 | Dm Properties of Rapides, LLC | Radiology | 2705 Highway 28 E Ste B, Pineville, LA 71360 | 2017-10-25 |
| 1508384587 | Marion Patrick Hazelton I | Counselor | Pathways Red River Treatment Center, 242 West Shamrock Ave Unit 6 Melody Lane, Pineville, LA 71360 | 2017-08-30 |
| 1669902557 | Jessica Williams | Social Worker | Unit 6 Wing A Meadow Lane, Pineville, LA 71360 | 2017-06-14 |
| 1104365840 | Naomi Gates | Social Worker | 242 W Shamrock Unit 1, Pineville, LA 71360 | 2017-02-14 |
| 1861930224 | Sharon Humphrey | Counselor | 5400 Service Rd B206, Pineville, LA 71360 | 2017-02-06 |
| Find all providers in zip 71360 | ||||
| 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 |
|---|---|---|---|---|
| 1659798015 | Briggs Mason Ahearn | Orthopaedic Surgery | 9101 Pineville Matthews Rd, Ste D, Pineville, NC 28134-8826 | 2014-03-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740897743 | Highland Clinic, A Prof Med Corp | Orthopaedic Surgery | 5025 Shed Rd, Bossier City, LA 71111-5434 | 2020-09-24 |
| 1437770435 | Cwd LLC | Orthopaedic Surgery | 2600 Belle Chasse Hwy Ste I, Terrytown, LA 70056-7156 | 2020-04-30 |
| 1982224556 | Great River Orthopedic and Sports Medicine Center, Inc. | Orthopaedic Surgery | 376 Cocoville Rd, Mansura, LA 71350-4264 | 2020-04-23 |
| 1962041954 | James R Lafleur | Orthopaedic Surgery | 122 Wembley Rd, Lafayette, LA 70503-3567 | 2019-12-23 |
| 1225504889 | George Andrews | Orthopaedic Surgery | Ochsner Health System, 1514 Jefferson Highway, New Orleans, LA 70121 | 2018-10-22 |
| 1467935965 | Marco Rodriguez Md LLC | Orthopaedic Surgery | 606 Colonial Dr Ste A, Baton Rouge, LA 70806-6535 | 2018-09-11 |
| 1114438140 | Oano LLC | Orthopaedic Surgery | 3434 Prytania St Ste 430, New Orleans, LA 70115-3525 | 2017-10-17 |
| 1972037166 | Collins Orthopaedics LLC | Orthopaedic Surgery | 250 S Beglis Parkway, Ste 3, Sulphur, LA 70663 | 2017-04-14 |
| 1164961975 | Lmg LLC | Orthopaedic Surgery | 14041 Highway 90, Boutte, LA 70039-3511 | 2017-02-14 |
| 1205385796 | Mid State Orthopaedic & Sports Medicine Center LLC | Orthopaedic Surgery | 601 W Lafayette St, Winnfield, LA 71483-3451 | 2016-09-26 |
| 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.