Active NPI
John B Sledge III, M.D.
- Orthopaedic Surgery Physician
- Los Angeles, CA
National Provider Identifier
1255319869
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- G172374
- Practice address
- 1018 S Gretna Green Way
Los Angeles, CA 90049-5831 - Phone
- (781) 254-7599
- NPI assigned
- Jan 4, 2006
- Last updated
- Jun 17, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | MD.205141 | LA | |
| Orthopaedic Surgery Physician | 207X00000X | G172374 | CA | Primary |
| Adult Reconstructive Orthopaedic Surgery Physician | 207XS0114X | 80940 | MA | |
| Orthopaedic Surgery of the Spine Physician | 207XS0117X | 80940 | MA |
Addresses
Primary practice location
1018 S Gretna Green Way
Los Angeles, CA 90049-5831
Mailing address
1018 S Gretna Green Way
Los Angeles, CA 90049-5831
Phone (781) 254-7599
Other practice location 1
1018 S Gretna Green Way
Los Angeles, CA 90049-5831
Phone (781) 254-7599
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| J31314 | Other | MA | BCBS |
| 733396 | Other | MA | TUFTS |
| 2183311 | Medicaid | LA | |
| 3145832 | Medicaid | MA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G172374 | CA | MD | Orthopaedic Surgery Physician |
| MD.205141 | LA | MD | Orthopaedic Surgery Physician |
| 80940 | MA | MD | Orthopaedic Surgery of the Spine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sports Medicine North Orthopaedic Surgery, Inc. | Past | Accepting new patients |
Interoperability endpoints
- jsledge@lbj.ssdirect.aprima.com
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Specialist
- Peabody, MA
- NPI 1760423719
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136332800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718582400000",
"number": "1255319869",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1018 S GRETNA GREEN WAY",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900495831",
"telephone_number": "781-254-7599"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1018 S GRETNA GREEN WAY",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900495831",
"telephone_number": "781-254-7599"
}
],
"practiceLocations": [
{
"address_1": "1018 S Gretna Green Way",
"address_purpose": "LOCATION",
"city": "Los Angeles",
"state": "CA",
"postal_code": "900495831",
"country_code": "US",
"telephone_number": "781-254-7599",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SLEDGE",
"first_name": "JOHN",
"middle_name": "B",
"name_prefix": "Dr.",
"name_suffix": "III",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-04",
"last_updated": "2024-06-17",
"certification_date": "2024-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "LA",
"license": "MD.205141",
"primary": false
},
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "CA",
"license": "G172374",
"primary": true
},
{
"code": "207XS0114X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
"state": "MA",
"license": "80940",
"primary": false
},
{
"code": "207XS0117X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
"state": "MA",
"license": "80940",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "J31314",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS",
"identifier": "733396",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2183311",
"state": "LA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3145832",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.