Ascendant Orthopedic Alliance, LLC

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

Legal business name

ASCENDANT ORTHOPEDIC ALLIANCE, LLC

Practice address

53880 Carmichael Dr
South Bend, IN 46635-1567

Phone

(574) 247-9441

Fax

(574) 247-9442

NPI assigned

Aug 16, 2017

Reactivated

May 22, 2019

Organization subpart

No

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

Authorized official

Name

Mrs. Susan R Yeary

Title

Director of Billing

Phone

(574) 247-6583

Specialties & licenses 5

Addresses

Other identifiers 1

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1502841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599004800000",
    "number": "1336665991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53880 CARMICHAEL DR",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466351567",
            "telephone_number": "574-247-9441",
            "fax_number": "574-247-9442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53880 CARMICHAEL DR",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466351567",
            "telephone_number": "574-247-9441",
            "fax_number": "574-247-9442"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "60101 Bodnar Blvd",
            "address_purpose": "LOCATION",
            "city": "Mishawaka",
            "state": "IN",
            "postal_code": "465449328",
            "country_code": "US",
            "telephone_number": "574-257-0510",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5218 Beck Dr",
            "address_purpose": "LOCATION",
            "city": "Elkhart",
            "state": "IN",
            "postal_code": "465169121",
            "country_code": "US",
            "telephone_number": "574-247-9441",
            "fax_number": "574-247-9442",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "900 I St",
            "address_purpose": "LOCATION",
            "city": "LA Porte",
            "state": "IN",
            "postal_code": "463505533",
            "country_code": "US",
            "telephone_number": "574-247-9441",
            "fax_number": "574-247-9442",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2349 Lake Ave Ste 201",
            "address_purpose": "LOCATION",
            "city": "Plymouth",
            "state": "IN",
            "postal_code": "465637837",
            "country_code": "US",
            "telephone_number": "574-247-9441",
            "fax_number": "574-247-9442",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ASCENDANT ORTHOPEDIC ALLIANCE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-16",
        "last_updated": "2020-09-02",
        "certification_date": "2020-09-02",
        "deactivation_date": "2019-05-20",
        "reactivation_date": "2019-05-22",
        "status": "A",
        "authorized_official_last_name": "YEARY",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "DIRECTOR OF BILLING",
        "authorized_official_telephone_number": "574-247-6583",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207XS0106X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "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": "2081S0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300009135",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.sbortho.com",
            "affiliation": "N",
            "endpointDescription": "Web address",
            "address_1": "53880 Carmichael Dr",
            "city": "South Bend",
            "state": "IN",
            "country_code": "US",
            "postal_code": "466351567",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Orthopaedic Surgery Physician in South Bend, IN
• Providers in South Bend, IN by specialty
• Orthopaedic Surgery Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 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.