NPIMap

Organization Active NPI

Ora Orthopedics PC

  • Orthopaedic Surgery Physician
  • Silvis, IL
National Provider Identifier
1114998416
Registry record updated Apr 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
060006850 Issued in IL
Legal business name
ORA ORTHOPEDICS PC
Practice address
985 Avenue of the Cities Ste 105
Silvis, IL 61282-7001
Phone
(309) 762-3621
Fax
(309) 281-2609
NPI assigned
Jan 27, 2006
Last updated
Apr 29, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
ORA ORTHOPEDICS PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 29, 2024

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

Authorized official

Name
Kenneth Brockman
Title
Ceo
Phone
(563) 322-0971

Specialties & licenses 9

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X NU
Neurological Surgery Physician 207T00000X NU
Orthopaedic Surgery Physician 207X00000X 060006850 IL Primary
Other Specialist/Technologist 246Z00000X NU
Durable Medical Equipment & Medical Supplies 332B00000X NU
Prosthetic/Orthotic Supplier 335E00000X NU
Medical Physician Assistant 363AM0700X NU
Surgical Physician Assistant 363AS0400X NU
Nurse Practitioner 363L00000X NU

Addresses

Primary practice location

985 Avenue of the Cities Ste 105
Silvis, IL 61282-7001

Mailing address

520 Valley View Dr
Moline, IL 61265-6194
Phone (309) 762-3621

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040407001036 IL Part B Supplier - Clinic/Group Practice 6406741784 Receives reassigned benefits from 123 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Geneseo, IL; Moline, IL; Rock Island, IL; Silvis, IL
O20100930035668 IL DME Supplier - Physician - Orthopedic/Orthopedic Surgery 6406741784 Practice locations: Silvis, IL

Other NPIs with the same Medicare PAC ID 8

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

Other NPIs on the same Medicare enrollment 6

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

National Provider Directory

National Provider Directory
Part of
Ortho Rheuma Assoc PC

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1138320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714348800000",
    "number": "1114998416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 VALLEY VIEW DR",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612656194",
            "telephone_number": "309-762-3621",
            "fax_number": "309-762-3690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "985 AVENUE OF THE CITIES STE 105",
            "city": "SILVIS",
            "state": "IL",
            "postal_code": "612827001",
            "telephone_number": "309-762-3621",
            "fax_number": "309-281-2609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORA ORTHOPEDICS PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ORA ORTHOPEDICS PC",
        "enumeration_date": "2006-01-27",
        "last_updated": "2024-04-29",
        "certification_date": "2024-04-29",
        "status": "A",
        "authorized_official_last_name": "BROCKMAN",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "563-322-0971"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "IL",
            "license": "060006850",
            "primary": true
        },
        {
            "code": "246Z00000X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Silvis, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 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.