Southeast Iowa Orthopedics & Sports Medicine PC

Primary specialty

SpecialistTaxonomy code 174400000X

License

26178 Issued in IA

Legal business name

SOUTHEAST IOWA ORTHOPEDICS & SPORTS MEDICINE PC

Practice address

903 Oak St
Burlington, IA 52601-4608

Phone

(319) 758-9133

Fax

(319) 758-9143

NPI assigned

Nov 5, 2007

Last updated

Apr 16, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Michael W Hendricks, MDNPI 1568482446

Title

Ceo

Phone

(319) 758-9133

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Southeast Iowa Open MRI

  • Magnetic Resonance Imaging (MRI) Clinic/Center
  • Burlington, IA
  • NPI 1528190485
  NPPES parent name

Practitioners 1

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.

• Michael W Hendricks, MD

  • Orthopaedic Surgery Physician
  • Burlington, IA
  • NPI 1568482446

  Specialist

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1194220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744761600000",
    "number": "1356521504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 156",
            "city": "BURLINGTON",
            "state": "IA",
            "postal_code": "526010156",
            "telephone_number": "319-758-9133",
            "fax_number": "319-758-9143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "903 OAK ST",
            "city": "BURLINGTON",
            "state": "IA",
            "postal_code": "526014608",
            "telephone_number": "319-758-9133",
            "fax_number": "319-758-9143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST IOWA ORTHOPEDICS & SPORTS MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-05",
        "last_updated": "2025-04-16",
        "certification_date": "2025-04-16",
        "status": "A",
        "authorized_official_last_name": "HENDRICKS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "319-758-9133",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IA",
            "license": "26178",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID ILLINOIS",
            "identifier": "267960871",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "46204",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1043539",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLANDS CHOICE",
            "identifier": "10954",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IAHS",
            "identifier": "30001",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "470000991",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Smile Shoppe
• Alisa Nicole Smith, LISW
• Mona Riley Smith, M.F.T.
• Southeast Iowa Area Agency on Aging, Inc.
• Southeast Iowa Open MRI
• Southeast Iowa Regional Medical Center, Inc. (Southeast Iowa Regional Medical Center)
• Sovereign Grace Therapy
• Cinnamon L Spear, OTR/L
• Arnold A Sperfslage, D.D.S.
• Spitz Eyecare LLC

• Specialist in Burlington, IA
• Providers in Burlington, IA by specialty
• Specialist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2025; 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.