Organization Active NPI

Mid South Orthopedic Associates PC

  • Orthopaedic Surgery Physician
  • Cordova, TN
National Provider Identifier
1003829664
Registry record updated Oct 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
28886 Issued in TN
Legal business name
MID SOUTH ORTHOPEDIC ASSOCIATES PC
Practice address
927 Cordova Station Ave
Cordova, TN 38018-6316
Phone
(901) 465-4300
Fax
(901) 465-3357
NPI assigned
Aug 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Lawrence F SchraderNPI 1811919335
Title
President
Phone
(901) 465-4300

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207X00000X 28886 TN Primary

Addresses

Primary practice location

927 Cordova Station Ave
Cordova, TN 38018-6316

Mailing address

927 Cordova Station Ave
Cordova, TN 38018-6316
Phone (901) 465-4300

Other identifiers 1

IdentifierTypeStateIssuer
0000028886MedicaidTN

Other names 1

  • SCHRADER ORTHOPEDICS AND STEM CELL TREATMENT CENTER, P.C. Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060829000201 TN Part B Supplier - Clinic/Group Practice 9032113345 Receives reassigned benefits from 1 practitioner
Practice locations: Cordova, TN

National Provider Directory

National Provider Directory

Locations

927 Cordova Station Ave
Cordova, TN 38018
Phone (901) 465-4300

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729728000000",
    "number": "1003829664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "927 CORDOVA STATION AVE",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380186316",
            "telephone_number": "901-465-4300",
            "fax_number": "901-465-3357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "927 CORDOVA STATION AVE",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380186316",
            "telephone_number": "901-465-4300",
            "fax_number": "901-465-3357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID SOUTH ORTHOPEDIC ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-14",
        "last_updated": "2024-10-24",
        "certification_date": "2024-10-24",
        "status": "A",
        "authorized_official_last_name": "SCHRADER",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "901-465-4300",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "TN",
            "license": "28886",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000028886",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SCHRADER ORTHOPEDICS AND STEM CELL TREATMENT CENTER, P.C.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cordova, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.