JACKSONVILLE ORTHOPEDIC CLINIC, P.A. (NPI# 1316090608) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316090608 |
| Entity Type | Organization |
| Organization Name | JACKSONVILLE ORTHOPEDIC CLINIC, P.A. |
| Practice Address |
128 Memorial Dr Jacksonville NC 28546-6328 |
| Practice Telephone | 9103534500 |
| Practice Fax Number | 9103535610 |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2008-03-04 |
| Authorized Official Name | DR. NOEL B ROGERS (PRESIDENT) |
| Authorized Official Telephone | 9103534500 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207X00000X | Orthopaedic Surgery | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 8901899 | 05 | |
| NC | BLUE CROS BLUE SHIELD | 01899 | 01 |
| Street Address |
128 MEMORIAL DR |
| City | JACKSONVILLE |
| State | NC |
| Zip Code | 28546-6328 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710953328 | Lisa B Mcintosh | Physical Therapist | 128 Memorial Dr, Jacksonville, NC 28546-6328 | 2006-02-23 |
| 1073557021 | Jeffrey Louis Gross | Orthopaedic Surgery | 128 Memorial Dr, Jacksonville, NC 28546-6328 | 2006-06-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316578388 | Judylyn Hobson | Registered Nurse | Pride In North Carolina, LLC, 3886 Henderson Dr, Jacksonville, NC 28546 | 2020-01-29 |
| 1427694637 | Aaron Patrick Bettcher | Military Health Care Provider | 3rd Mrb Loop Rd, Camp Lejeune, NC 28546 | 2019-11-22 |
| 1962044289 | Levi Scott Marshall | Military Health Care Provider | Everett Creek Road, Building 612, Camp Lejeune, NC 28546 | 2019-10-09 |
| 1649826652 | Nicholas Otazo | Military Health Care Provider | 3rd Mrb 20073, Camp Lejeune, NC 28546 | 2019-08-15 |
| 1417519570 | Publix North Carolina, Lp | Durable Medical Equipment & Medical Supplies | 2001 Marlin Drive Unit 100, Jacksonville, NC 28546 | 2019-06-28 |
| 1023500212 | Josip Ninrodriguez | Military Health Care Provider | 3d Marine Raider Battaliom, Camp Lejeune, NC 28546 | 2018-06-04 |
| 1639661192 | Kenneth Lee Russell | Military Health Care Provider | 3d Marine Raider Battalion, Camp Lejeune, NC 28546 | 2018-05-31 |
| 1346730173 | Coastal Foot Center, LLC | Clinic/Center | 29 Office Park Dr Ste B, Jacksonville, NC 28546 | 2018-05-17 |
| 1578080271 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 380 Western Blvd, Jacksonville, NC 28546 | 2017-08-24 |
| 1144757493 | Darin Lee Peterson | Specialist/Technologist | G644 Camp Geiger, School of Infantry-east, Jacksonville, NC 28546 | 2017-05-17 |
| Find all providers in zip 28546 | ||||
| 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 |
|---|---|---|---|---|
| 1609483155 | Ortholonestar, Pllc | Orthopaedic Surgery | 203 Nacogdoches St Ste 350, Jacksonville, TX 75766-2454 | 2020-09-29 |
| 1437719853 | North Florida Surgeons, Pa | Orthopaedic Surgery | 2 Shirlciff Ways, Suite 300, Jacksonville, FL 32204 | 2019-06-18 |
| 1013478403 | David William Barton | Orthopaedic Surgery | 655 W 8th St, Box C-126, Jacksonville, FL 32209 | 2019-03-27 |
| 1083093991 | John Wunn Cancian Sr. | Orthopaedic Surgery | Bumed, Centralized Credential and Privileging Directora, 554 Keily Street, Jacksonville, FL 32212 | 2015-05-26 |
| 1124463088 | Eric G Kim | Orthopaedic Surgery | 2 Shircliff Way Ste 605, Jacksonville, FL 32204-4762 | 2013-05-06 |
| 1508124439 | Conor Brendan Garry | Orthopaedic Surgery | Bureau of Medicine and Surgery, Central Credentialing, 554 Keily St, Jacksonville, FL 32212 | 2012-04-28 |
| 1386924298 | George El-bahri | Orthopaedic Surgery | 6100 Kennerly Rd Ste 101, Jacksonville, FL 32216-4376 | 2011-08-23 |
| 1659667012 | Michael C Freidl | Orthopaedic Surgery | Uf Health - North, 15255 Max Leggett Parkway - Suite 6600, Jacksonville, FL 32218 | 2011-06-23 |
| 1780902643 | John Webster Williams Jr. | Orthopaedic Surgery | 4416 Gadsden Ct, Jacksonville, FL 32207-6216 | 2010-05-17 |
| 1265604599 | Asher O Smith | Orthopaedic Surgery | 2080 Child Street Naval Hospital Jacksonville, Jacksonville, FL 32214-2538 | 2008-03-27 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 28546 |
Please comment or provide details below to improve the information on JACKSONVILLE ORTHOPEDIC CLINIC, P.A..
| 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.