Organization Active NPI

Texas Institute of Orthopedic Surgery & Sports Medicine PLLC

  • Orthopaedic Surgery Physician
  • Grapevine, TX
National Provider Identifier
1356484638
Registry record updated Apr 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
TEXAS INSTITUTE OF ORTHOPEDIC SURGERY & SPORTS MEDICINE PLLC
Practice address
815 Ira E Woods Ave
Ste 100
Grapevine, TX 76051-4012
Phone
(817) 421-0505
Fax
(817) 421-6060
NPI assigned
Feb 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2014

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

Authorized official

Name
Shannon Jordan
Title
Office Manager
Phone
(817) 421-0505

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207X00000X Primary

Addresses

Primary practice location

815 Ira E Woods Ave
Ste 100
Grapevine, TX 76051-4012

Mailing address

815 Ira E Woods Ave
Ste 100
Grapevine, TX 76051-4012
Phone (817) 421-0505

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20110413000220 TX Part B Supplier - Clinic/Group Practice 0840474037 Receives reassigned benefits from 4 practitioners
Practice locations: Grapevine, TX
O20131210000142 TX DME Supplier - Physician - Orthopedic/Orthopedic Surgery 0840474037 Practice locations: Grapevine, TX

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FIDCCD

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397692800000",
    "number": "1356484638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 IRA E WOODS AVE",
            "address_2": "STE 100",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760514012",
            "telephone_number": "817-421-0505",
            "fax_number": "817-421-6060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 IRA E WOODS AVE",
            "address_2": "STE 100",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760514012",
            "telephone_number": "817-421-0505",
            "fax_number": "817-421-6060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEXAS INSTITUTE OF ORTHOPEDIC SURGERY & SPORTS MEDICINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-15",
        "last_updated": "2014-04-17",
        "status": "A",
        "authorized_official_last_name": "JORDAN",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "817-421-0505"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grapevine, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2014; 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.