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Organization Active NPI

Orthopaedic and Sports Medicine Center-Norman, P.C.

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Norman, OK
National Provider Identifier
1306854765
Registry record updated Apr 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
Legal business name
ORTHOPAEDIC AND SPORTS MEDICINE CENTER-NORMAN, P.C.
Practice address
825 E Robinson St
Norman, OK 73071-6610
Phone
(405) 364-7900
Fax
(405) 364-6719
NPI assigned
Aug 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2023

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

Authorized official

Name
Emily Wainner
Title
Credentialing
Phone
(405) 310-6881

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Hand Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207XS0106X
Orthopaedic Surgery of the Spine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207XS0117X
Orthopaedic Foot and Ankle Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207XX0004X
Sports Medicine (Orthopaedic Surgery) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207XX0005X Primary

Addresses

Primary practice location

825 E Robinson St
Norman, OK 73071-6610

Mailing address

825 E Robinson St
Norman, OK 73071-6610
Phone (405) 364-7900

Other identifiers 1

IdentifierTypeStateIssuer
100731030AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040402001197 OK Part B Supplier - Clinic/Group Practice 2567454937 Receives reassigned benefits from 5 practitioners
Practice locations: Yukon, OK; Stillwater, OK; Oklahoma City, OK; Norman, OK; Moore, OK; Midwest City, OK
O20100930025081 OK DME Supplier - Physician - Orthopedic/Orthopedic Surgery 2567454937 Practice locations: Norman, OK

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Locations

5575 N Council Ave
Blanchard, OK 73010
Phone (405) 597-2194

21001 SE 29th St
#3
Harrah, OK 73045
Phone (405) 768-5749

1117 S Douglas Blvd
Ste D
Oklahoma City, OK 73130
Phone (405) 739-6596

Practitioners & affiliated clinicians

Practitioners 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681171200000",
    "number": "1306854765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 E ROBINSON ST",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730716610",
            "telephone_number": "405-364-7900",
            "fax_number": "405-364-6719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 E ROBINSON ST",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730716610",
            "telephone_number": "405-364-7900",
            "fax_number": "405-364-6719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOPAEDIC AND SPORTS MEDICINE CENTER-NORMAN, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-03",
        "last_updated": "2023-04-11",
        "certification_date": "2023-04-11",
        "status": "A",
        "authorized_official_last_name": "WAINNER",
        "authorized_official_first_name": "EMILY",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "405-310-6881"
    },
    "taxonomies": [
        {
            "code": "207XS0106X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207XX0004X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Foot and Ankle Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100731030A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norman, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.