Southern Orthopaedic Sports Medicne

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

License

19175 Issued in SC

Legal business name

SOUTHERN ORTHOPAEDIC SPORTS MEDICNE

Practice address

1718 Saint Julian PL
Columbia, SC 29204-2410

Phone

(803) 376-8880

Fax

(803) 376-8881

NPI assigned

May 5, 2006

Organization subpart

No

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

Authorized official

Name

Evan Franklin Ekman, M.D.

Title

President

Phone

(803) 376-8880

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193184000000",
    "number": "1013965789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1718 SAINT JULIAN PL",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292042410",
            "telephone_number": "803-376-8880",
            "fax_number": "803-376-8881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1718 SAINT JULIAN PL",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292042410",
            "telephone_number": "803-376-8880",
            "fax_number": "803-376-8881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN ORTHOPAEDIC SPORTS MEDICNE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-05",
        "last_updated": "2007-10-24",
        "status": "A",
        "authorized_official_last_name": "EKMAN",
        "authorized_official_first_name": "EVAN",
        "authorized_official_middle_name": "FRANKLIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "803-376-8880",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "SC",
            "license": "19175",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP2755",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Southeastern Medical Supply Inc
• Joel Allyn Southerlin II, LISW-CP
• Southern Cardiac Imaging, LLC
• Southern Home Care Services, Inc.
• Southern Orthopaedic Physical Therapy,LLC
• Southern Pain Specialists
• Southern Roots Periodontics: Implant & Laser Dentistry, LLC
• Southern Smiles Dental Studio Columbia LLC
• Southerncare, Inc.
• Lisa Anne Southworth, LPC

• Sports Medicine (Orthopaedic Surgery) Physician in Columbia, SC
• Providers in Columbia, SC by specialty
• Sports Medicine (Orthopaedic Surgery) Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.