Southern Orthopedic Associates, S.C.

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

36333 Issued in KY

Legal business name

SOUTHERN ORTHOPEDIC ASSOCIATES, S.C.

Doing business as

Orthopedic Institute of Western Kentucky

Practice address

3530 Lone Oak Rd
Ste a
Paducah, KY 42003-5752

Phone

(270) 554-0505

Fax

(270) 554-0905

NPI assigned

Aug 29, 2005

Last updated

Jan 10, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Thomas W Davis, M.D.NPI 1295842870

Title

President

Phone

(618) 997-6800

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• ORTHOPEDIC INSTITUTE OF WESTERN KENTUCKY Doing business as

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Enterprise Medical, Inc

  • Durable Medical Equipment & Medical Supplies
  • Paducah, KY
  • NPI 1629186499

  Member Of

  NPD member

Locations

Practitioners 2

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.

• Thomas West Davis, MD

  • Orthopaedic Surgery Physician
  • Herrin, IL
  • NPI 1295842870
  Authorized official Same address or phone
• Frederick Thane Deweese, M.D.

  • Orthopaedic Surgery Physician
  • Paducah, KY
  • NPI 1891784757
  NPD (past)

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

{
    "created_epoch": "1125273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294617600000",
    "number": "1225021819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 LINCOLN DR",
            "city": "HERRIN",
            "state": "IL",
            "postal_code": "629486334",
            "telephone_number": "618-997-6800",
            "fax_number": "618-998-9124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3530 LONE OAK RD",
            "address_2": "STE A",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420035752",
            "telephone_number": "270-554-0505",
            "fax_number": "270-554-0905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN ORTHOPEDIC ASSOCIATES, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-29",
        "last_updated": "2011-01-10",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "618-997-6800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "KY",
            "license": "36333",
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IL",
            "license": "042617215",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100080520",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ORTHOPEDIC INSTITUTE OF WESTERN KENTUCKY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Shelby Nicole Snow, APRN, FNP-BC
• Jared Snowaert
• Janet Marie Solomon, MSWPSC
• Sheahahn Vikash Soundranayagam, MD
• Joel Lynn Southerland, R.PH.
• Southern Orthopedic Associates, S.C. (Orthopedic Institute of Western Kentucky)
• Southern Orthopedic Associates, S.C. (Orthopedic Institute of Western Kentucky)
• Southern Orthopedic Associates, S.C. (Orthopedic Institute of Western Kentucky)
• Southern Pain and Rehabilitation Inc (Elite Pain and Spine)
• Southern Rose Psychotherapy, LLC

• Orthopaedic Surgery Physician in Paducah, KY
• Providers in Paducah, KY by specialty
• Orthopaedic Surgery Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2011; 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.