Organization Active NPI

Mountain Lake Orthopedics

  • Orthopaedic Surgery Physician
  • Cullman, AL
National Provider Identifier
1366522856
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
13890 Issued in AL
Legal business name
MOUNTAIN LAKE ORTHOPEDICS
Practice address
1912 Cherokee Ave SW
Suite 3200
Cullman, AL 35055-5595
Phone
(256) 736-5505
Fax
(256) 736-5551
NPI assigned
Oct 17, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
John Eugene Songer, M.D.NPI 1922188564
Title
President
Phone
(256) 736-5505

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 13890 AL Primary

Addresses

Primary practice location

1912 Cherokee Ave SW
Suite 3200
Cullman, AL 35055-5595

Mailing address

1912 Cherokee Ave SW
Suite 3200
Cullman, AL 35055-5595
Phone (256) 736-5505

National Provider Directory

National Provider Directory

Locations

605 Medical Center Pkwy
#A
Boaz, AL 35957
Phone (256) 593-0331

1912 Cherokee Ave SW
Ste 3200
Cullman, AL 35055
Phone (256) 571-8501

Practitioners & affiliated clinicians

Practitioners 2

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": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1366522856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1912 CHEROKEE AVE SW",
            "address_2": "SUITE 3200",
            "city": "CULLMAN",
            "state": "AL",
            "postal_code": "350555595",
            "telephone_number": "256-736-5505",
            "fax_number": "256-736-5551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1912 CHEROKEE AVE SW",
            "address_2": "SUITE 3200",
            "city": "CULLMAN",
            "state": "AL",
            "postal_code": "350555595",
            "telephone_number": "256-736-5505",
            "fax_number": "256-736-5551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN LAKE ORTHOPEDICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SONGER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "EUGENE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "256-736-5505",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "AL",
            "license": "13890",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cullman, AL

Sources for this page

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