Lincoln Orthopedic Group LTD.

Primary specialty

Sports Medicine (Neuromusculoskeletal Medicine) PhysicianTaxonomy code 204C00000X

License

30083 Issued in WI

Legal business name

LINCOLN ORTHOPEDIC GROUP LTD.

Practice address

9400 W Lincoln Avenue
West Allis, WI 53227-2306

Phone

(414) 545-4646

Fax

(414) 545-5227

NPI assigned

Oct 31, 2006

Last updated

Aug 22, 2020By 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. Jeffrey B. Shovers, M.D.

Title

President

Phone

(414) 545-4646

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1225114218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9400 W LINCOLN AVE",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532272306",
            "telephone_number": "414-545-4646",
            "fax_number": "414-545-5227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9400 W LINCOLN AVENUE",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532272306",
            "telephone_number": "414-545-4646",
            "fax_number": "414-545-5227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LINCOLN ORTHOPEDIC GROUP LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHOVERS",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "414-545-4646",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "204C00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine, Sports Medicine",
            "state": "WI",
            "license": "30083",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31506100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Sports Medicine (Neuromusculoskeletal Medicine) Physician in West Allis, WI
• Providers in West Allis, WI by specialty
• Sports Medicine (Neuromusculoskeletal Medicine) Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.