Ortho Plus Holdings LLC

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

Legal business name

ORTHO PLUS HOLDINGS LLC

Practice address

12301 S Western Ave Ste A3
Oklahoma City, OK 73170-6085

Phone

(405) 676-8643

Fax

(405) 676-8644

NPI assigned

Sep 20, 2021

Organization subpart

No

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

Authorized official

Name

Brent Keith Holliman, PA

Title

Manager / Owner

Phone

(405) 227-1280

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Ortho Plus Holdings LLC

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Oklahoma City, OK
  • NPI 1548620529

  0345586822

  Same PAC ID

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/18605/brand/1/csg/1/fhir/r4

Practitioners 3

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

• James Jason Jackson, MD

  • Physical Medicine & Rehabilitation Physician
  • Edmond, OK
  • NPI 1760646392
  NPD
• Mark Daniel Johnson, PA-C

  • Surgical Physician Assistant
  • Oklahoma City, OK
  • NPI 1508855677
  NPD
• Michael Sean Obrien, D.O.

  • Orthopaedic Surgery Physician
  • Oklahoma City, OK
  • NPI 1164496238
  NPD

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

{
    "created_epoch": "1632096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714003200000",
    "number": "1023788098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 LILAC DR STE 140",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730347288",
            "telephone_number": "405-676-8643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12301 S WESTERN AVE STE A3",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731706085",
            "telephone_number": "405-676-8643",
            "fax_number": "405-676-8644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHO PLUS HOLDINGS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-20",
        "last_updated": "2024-04-25",
        "certification_date": "2024-04-25",
        "status": "A",
        "authorized_official_last_name": "HOLLIMAN",
        "authorized_official_first_name": "BRENT",
        "authorized_official_middle_name": "KEITH",
        "authorized_official_title_or_position": "MANAGER / OWNER",
        "authorized_official_telephone_number": "405-227-1280",
        "authorized_official_credential": "PA"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200810750C",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Austin Paul Ortega
• Beatriz Andrea Ortega, CPRSS
• Carissa Rhea Ortega, MSN, APRN, CPNP-AC/P
• David Ortega, CASE MANAGER
• Erika Ortega, CPRSS
• Ortho Plus Holdings LLC
• Orthodontic Associates
• Orthodontic Partners of Oklahoma, PLLC
• Orthopaedic & Sports Specialists PC
• Orthopaedic Medical Solutions, LLC

• Sports Medicine (Orthopaedic Surgery) Physician in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Sports Medicine (Orthopaedic Surgery) Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 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.