Bonutti Orthopedic Services LTD

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

060005120 Issued in IL

Legal business name

BONUTTI ORTHOPEDIC SERVICES LTD

Doing business as

Sarah Bush Lincoln Bonutti Clinic

Practice address

1303 W Evergreen Ave
Suite 101
Effingham, IL 62401

Phone

(217) 342-3400

Fax

(217) 342-6416

NPI assigned

May 17, 2006

Organization subpart

Yes

Parent organization

PRACTICE ACQUISITION INCAs reported in NPPES

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

Authorized official

Name

Dennis Pluard

Title

Cfo & VP of Operations

Phone

(217) 258-2102

Specialties & licenses 5

Addresses

Other identifiers 2

Other names 1

• Sarah Bush Lincoln Bonutti Clinic Doing business as

Member of 2

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

• Biomax Rehabilitation Services, Inc

  • Prosthetic/Orthotic Supplier
  • Effingham, IL
  • NPI 1821186578

  Member Of

  NPD member
• Joint Active Systems, Inc

  • Customized Equipment (DME)
  • Effingham, IL
  • NPI 1639172331

  Member Of

  NPD member

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

• Biomax Rehabilitation Services, Inc

  • Prosthetic/Orthotic Supplier
  • Effingham, IL
  • NPI 1821186578

  Member Of

  NPD member
• Joint Active Systems, Inc

  • Customized Equipment (DME)
  • Effingham, IL
  • NPI 1639172331

  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.

• Josue Peretra Gabriel, MD

  • Orthopaedic Surgery of the Spine Physician
  • Hilliard, OH
  • NPI 1376506824
  NPD
• Andrew Vannatta, CO

  • Orthotist
  • Effingham, IL
  • NPI 1134493042
  NPD (past)

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1526947200000",
    "number": "1285687996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1303 W EVERGREEN AVE STE 101",
            "city": "EFFINGHAM",
            "state": "IL",
            "postal_code": "624011619",
            "telephone_number": "217-342-3400",
            "fax_number": "217-342-6416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1303 W EVERGREEN AVE",
            "address_2": "SUITE 101",
            "city": "EFFINGHAM",
            "state": "IL",
            "postal_code": "62401",
            "telephone_number": "217-342-3400",
            "fax_number": "217-342-6416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BONUTTI ORTHOPEDIC SERVICES LTD",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PRACTICE ACQUISITION INC",
        "enumeration_date": "2006-05-17",
        "last_updated": "2018-05-22",
        "status": "A",
        "authorized_official_last_name": "PLUARD",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_title_or_position": "CFO & VP OF OPERATIONS",
        "authorized_official_telephone_number": "217-258-2102"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "IL",
            "license": "060005120",
            "primary": true
        },
        {
            "code": "207XS0106X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": "IL",
            "license": "060005120",
            "primary": false
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "2083S0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Preventive Medicine, Sports Medicine",
            "state": "IL",
            "license": "060005120",
            "primary": false
        },
        {
            "code": "2083X0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "IL",
            "license": "060005120",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "166708",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUE SHIELD",
            "identifier": "2500074",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sarah Bush Lincoln Bonutti Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Peter Theodorus Bleeker, OTR/L
• Elaine Marie Blievernicht
• Cynthia Lynn Bloemker, COTA/L
• Jacy Lyn Blunt
• Emily Schultz Boll, FNP-C
• Peter M. Bonutti, M.D.
• Kevin Paul Borntreger, D.C.
• Rose Catherine Borries, MOTR/L
• Jay A Borum, D.C.
• Emily S. Boyajian, APN

• Orthopaedic Surgery Physician in Effingham, IL
• Providers in Effingham, IL by specialty
• Orthopaedic Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2018; 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.