Southwest Minnesota Orthopedics and Sports Medicine, Inc

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

37196 Issued in MN

Legal business name

SOUTHWEST MINNESOTA ORTHOPEDICS AND SPORTS MEDICINE, INC

Practice address

1401 Nwakama St
Suite 300
Marshall, MN 56258-5529

Phone

(507) 929-7696

Fax

(507) 393-7697

NPI assigned

Dec 29, 2006

Organization subpart

No

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

Authorized official

Name

Jody L Jackels, RN

Title

Office Manager

Phone

(507) 393-7696

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Southwest Minnesota and Sports Medicine, Inc. - (Marshall) Doing business as

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Southwest Minnesota Orthopedics and Sports Medicine, Inc.

  • Orthopaedic Surgery Physician
  • Slayton, MN
  • NPI 1083778021

  O20041005001000

  Same enrollment

Locations

Practitioners 1

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

• Anthony C Nwakama, MD

  • Orthopaedic Surgery Physician
  • Slayton, MN
  • NPI 1588778658
  NPD

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

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268870400000",
    "number": "1063578466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2331 20TH ST",
            "city": "SLAYTON",
            "state": "MN",
            "postal_code": "561721004",
            "telephone_number": "507-393-7696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 NWAKAMA ST",
            "address_2": "SUITE 300",
            "city": "MARSHALL",
            "state": "MN",
            "postal_code": "562585529",
            "telephone_number": "507-929-7696",
            "fax_number": "507-393-7697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST MINNESOTA ORTHOPEDICS AND SPORTS MEDICINE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-29",
        "last_updated": "2010-03-18",
        "status": "A",
        "authorized_official_last_name": "JACKELS",
        "authorized_official_first_name": "JODY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "507-393-7696",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "MN",
            "license": "37196",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "667522100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southwest Minnesota and Sports Medicine, Inc. - (Marshall)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Alyssa Marie Snyder, O.D.
• Southwest Child Therapy Center
• Southwest Health and Human Services
• Southwest Health and Human Services
• Southwest Minnesota Lactation and Beyond, LLC
• Southwest Minnesota State University Student Health Services
• Southwest Minnesota Surgical Center, Inc.
• Southwest Ophthalmology Associates, P.a.
• Southwest Transportation, Inc.
• Southwestern Minnesota Adult Mental Health Consortium

• Orthopaedic Surgery Physician in Marshall, MN
• Providers in Marshall, MN by specialty
• Orthopaedic Surgery Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2010; 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.