ORTHOPEDIC SPECIALISTS & SPORTS MEDICINE, INC. (NPI# 1710983200) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710983200 |
| Entity Type | Organization |
| Organization Name | ORTHOPEDIC SPECIALISTS & SPORTS MEDICINE, INC. |
| Other Organization Name | ORTHOPEDIC SPECIALISTS |
| Practice Address |
1980 Tamarack Rd Newark OH 43055-1363 |
| Practice Telephone | 7407889220 |
| Practice Fax Number | 7407889226 |
| Mailing Telephone | 7407889220 |
| Mailing Fax Number | 7407889226 |
| Enumeration Date | 2005-06-21 |
| Last Update Date | 2019-11-21 |
| Authorized Official Name | DR. DAVID MOORE JACKSON (PRESIDENT) |
| Authorized Official Telephone | 7407889220 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 35047273 | OH | Other Service Providers |
| Other Name | Type Code |
|---|---|
| Orthopedic Specialists | Other Name - Individual/Organization |
| Street Address |
1980 TAMARACK RD |
| City | NEWARK |
| State | OH |
| Zip Code | 43055-1363 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790339729 | Mckayla Nicole Linz | Physical Therapist | 1980 Tamarack Rd, Newark, OH 43055-1363 | 2019-07-29 |
| 1821658030 | Connor Mcmahon | Physical Medicine & Rehabilitation | 1980 Tamarack Rd, Newark, OH 43055-1363 | 2019-06-19 |
| 1538669015 | Adam Daniel Schmidt | Physician Assistant | 1980 Tamarack Rd, Newark, OH 43055-1363 | 2018-02-20 |
| 1598129124 | Docid1 | Orthopaedic Surgery | 1980 Tamarack Rd, Newark, OH 43055-1363 | 2016-04-10 |
| 1578935367 | Docoh1, LLC | Plastic Surgery | 1980 Tamarack Rd, Newark, OH 43055-1363 | 2015-10-20 |
| 1710196761 | Michael Anthony Vaccariello | Orthopaedic Surgery | 1980 Tamarack Rd, Newark, OH 43055-1363 | 2007-05-22 |
| 1437207511 | Robert Chad Barnes | Registered Nurse | 1980 Tamarack Rd, Newark, OH 43055-1363 | 2007-01-08 |
| 1700934924 | Roberta Sue Giblin | Registered Nurse | 1980 Tamarack Rd, Newark, OH 43055-1363 | 2007-01-05 |
| 1659392074 | David M Jackson | Orthopaedic Surgery | 1980 Tamarack Rd, Newark, OH 43055-1363 | 2006-07-21 |
| 1316968746 | John D Quimjian | Orthopaedic Surgery | 1980 Tamarack Rd, Newark, OH 43055-1363 | 2006-07-21 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770125585 | Jessica Danielle Dunkle | Case Manager/Care Coordinator | 15 N 3rd Street Suite 300, Newark, OH 43055 | 2019-10-14 |
| 1558910331 | Diana Cleland | Home Health Aide | 25 Western Rd, Apartment A, Newark, OH 43055 | 2019-09-05 |
| 1912424789 | Sandra Lou Fraley | Community/Behavioral Health | 15 North 3rd Street, Suite 300, Newark, OH 43055 | 2017-08-23 |
| 1215450911 | Caitlyn Thella Smith Elkins | Social Worker | 15 N. 3rd St., Newark, OH 43055 | 2017-07-25 |
| 1992227888 | Sierra Elizabeth Donley | Student in an Organized Health Care Education/Training Program | 140 W Church St, Newark, OH 43055 | 2017-07-12 |
| 1386170587 | Patricia Louise Fischer | Pharmacist | 1155 North 21rst Street, Newark, OH 43055 | 2017-05-08 |
| 1689120958 | Bebout Services, LLC | Home Health | 1325 Dayton Road Ne, Newark, OH 43055 | 2016-08-28 |
| 1750834594 | Laura Smith | Registered Nurse | 1445 West Main Street, Suite B, Newark, OH 43055 | 2016-07-28 |
| 1164807277 | Frank Kobe | Psychologist | 116 N. 21st Street, Newark, OH 43055 | 2015-07-30 |
| 1770975898 | Gentle Foot Care, Inc | Podiatrist | 1271 W Main Street, Bldg 1, Newark, OH 43055 | 2015-02-26 |
| Find all providers in zip 43055 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811426133 | Darrell Eugene Roberson | Specialist | 243 Halsey St Apt 5c, Newark, NJ 07102-3750 | 2017-06-09 |
| 1497109771 | Amy Karlyna Iturburo | Specialist | 452 Highland Ave, Newark, NJ 07104-1518 | 2016-04-22 |
| 1003213380 | Rachel Ann Gerber | Specialist | 119 Union Street, Newark, OH 43055 | 2014-12-02 |
| 1821425356 | Paige Thomasson | Specialist | 35 Edison Place #402, Newark, NJ 07102 | 2013-09-30 |
| 1538508221 | Sarah Diane Johnson | Specialist | 347 Lake St, Apt C5, Newark, NJ 07104-1223 | 2013-06-17 |
| 1326381575 | Cecilia Asare | Specialist | 30-32 Crawford St, 3floor, Newark, NJ 07102-1100 | 2013-04-05 |
| 1912216573 | Persante Sleep Care, Inc. | Specialist | One Centurian Drive Ste: 208, Abby Medical Center, Newark, DE 19713-2137 | 2010-09-30 |
| 1205165321 | James M Bastianelli | Specialist | 28 Dublin Dr, Newark, DE 19702-7708 | 2009-12-19 |
| 1932332848 | Alternative Therapy | Specialist | 4631 Ogletown Stanton Rd, Newark, DE 19713-2006 | 2009-08-25 |
| 1508005083 | Jodi Lynn Collins | Specialist | 202 N Bridlewood Dr, Newark, DE 19702-3418 | 2009-02-06 |
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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.