NPIMap

Organization Active NPI

Belleville Orthopedics, P.C.

  • Specialist
  • Belleville, IL
National Provider Identifier
1275618480
Registry record updated Jan 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
036085921 Issued in IL
Legal business name
BELLEVILLE ORTHOPEDICS, P.C.
Practice address
4550 Memorial Dr
Suite 460
Belleville, IL 62226-5359
Phone
(618) 235-2900
Fax
(618) 235-2902
NPI assigned
Oct 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2009

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

Authorized official

Name
Dr. Harvey L Mirly, M.D.NPI 1447203971
Title
Owner/President
Phone
(618) 235-2900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 036085921 IL Primary

Addresses

Primary practice location

4550 Memorial Dr
Suite 460
Belleville, IL 62226-5359

Mailing address

4550 Memorial Dr
Suite 460
Belleville, IL 62226-5359
Phone (618) 235-2900

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231977600000",
    "number": "1275618480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4550 MEMORIAL DR",
            "address_2": "SUITE 460",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622265359",
            "telephone_number": "618-235-2900",
            "fax_number": "618-235-2902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4550 MEMORIAL DR",
            "address_2": "SUITE 460",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622265359",
            "telephone_number": "618-235-2900",
            "fax_number": "618-235-2902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BELLEVILLE ORTHOPEDICS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-26",
        "last_updated": "2009-01-15",
        "status": "A",
        "authorized_official_last_name": "MIRLY",
        "authorized_official_first_name": "HARVEY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "618-235-2900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "IL",
            "license": "036085921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belleville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2009; 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.