Orthonorthrup PA

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

License

OS7217 Issued in FL

Legal business name

ORTHONORTHRUP PA

Doing business as

Spartan Orthopedic Institute

Practice address

475 W Town PL Ste 106
St Augustine, FL 32092-2820

Phone

(904) 466-1179

Fax

(904) 823-8967

NPI assigned

Aug 18, 2017

Organization subpart

No

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

Authorized official

Name

Tod NorthrupNPI 1386622496

Title

Medical Director, Owner

Phone

(904) 466-1197

Specialties & licenses 1

Addresses

Other names 1

• Spartan Orthopedic Institute Doing business as

Medicare fee-for-service enrollment

Enrolled in FL2 enrollments

Enrollment records 2

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tod Northrup, D.O.

  • Sports Medicine (Orthopaedic Surgery) Physician
  • St Augustine, FL
  • NPI 1386622496
  Medicare reassignment NPD Authorized official
• Melissa Sepe, APRN

  • Family Nurse Practitioner
  • Ormond Beach, FL
  • NPI 1396222824

  Sports Medicine

  Medicare reassignment NPD

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

{
    "created_epoch": "1503014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1386160513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4389",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320854389",
            "telephone_number": "904-466-1197",
            "fax_number": "904-823-8967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 W TOWN PL STE 106",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320922820",
            "telephone_number": "904-466-1179",
            "fax_number": "904-823-8967"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "150 Southpark Blvd Ste 102",
            "address_purpose": "LOCATION",
            "city": "St Augustine",
            "state": "FL",
            "postal_code": "320865122",
            "country_code": "US",
            "telephone_number": "904-823-3764",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ORTHONORTHRUP PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-18",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "NORTHRUP",
        "authorized_official_first_name": "TOD",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR, OWNER",
        "authorized_official_telephone_number": "904-466-1197"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "FL",
            "license": "OS7217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Spartan Orthopedic Institute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Eric Ordonez, PTA
• Kristen Orlando
• Stacey Orner, RD, LD, MFN
• Anna Katharine Ortega
• Ortho Visits LLC
• Orthopaedic Assoc of St Augustine PA
• Louise Osborn, LM, CPM, LMHC
• Matthew Peter Herman Osborn, DPT
• Katelyn Ostopick, M.ED, ATC
• Kristen Ostrega

• Sports Medicine (Orthopaedic Surgery) Physician in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Sports Medicine (Orthopaedic Surgery) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.