Jack Purdy MD Inc

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

G31387 Issued in CA

Legal business name

JACK PURDY MD INC

Practice address

17525 Ventura Blvd Ste 203
Encino, CA 91316-5109

Phone

(818) 986-0200

Fax

(818) 986-4393

NPI assigned

Oct 18, 2007

Organization subpart

No

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

Authorized official

Name

Jack C Purdy, M.D.

Title

Owner/ Ceo Physcian and Surgeon

Phone

(310) 453-3533

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1192665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1267142400000",
    "number": "1154510899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17525 VENTURA BLVD STE 203",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913165109",
            "telephone_number": "818-986-0200",
            "fax_number": "818-986-4393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17525 VENTURA BLVD STE 203",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913165109",
            "telephone_number": "818-986-0200",
            "fax_number": "818-986-4393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACK PURDY MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-18",
        "last_updated": "2010-02-26",
        "status": "A",
        "authorized_official_last_name": "PURDY",
        "authorized_official_first_name": "JACK",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER/ CEO PHYSCIAN AND SURGEON",
        "authorized_official_telephone_number": "310-453-3533",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "G31387",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "G31387",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Orthopaedic Surgery Physician in Encino, CA
• Providers in Encino, CA by specialty
• Orthopaedic Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2010; 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.