Northpark Orthopaedics, PA

Primary specialty

Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X

License

J0438 Issued in TX

Legal business name

NORTHPARK ORTHOPAEDICS, PA

Practice address

8220 Walnut Hill LN
Suite 608
Dallas, TX 75231-4427

Phone

(214) 987-3434

Fax

(214) 987-3799

NPI assigned

Apr 23, 2007

Organization subpart

No

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

Authorized official

Name

Charles Jack Banta II, M.D.

Title

Physician

Phone

(214) 987-3434

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 1

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

• Charles Jack Banta II, MD

  • Orthopaedic Surgery of the Spine Physician
  • Dallas, TX
  • NPI 1205848512
  Medicare reassignment NPD

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193616000000",
    "number": "1386862654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8220 WALNUT HILL LN",
            "address_2": "SUITE 608",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752314427",
            "telephone_number": "214-987-3434",
            "fax_number": "214-987-3799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8220 WALNUT HILL LN",
            "address_2": "SUITE 608",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752314427",
            "telephone_number": "214-987-3434",
            "fax_number": "214-987-3799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHPARK ORTHOPAEDICS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-23",
        "last_updated": "2007-10-29",
        "status": "A",
        "authorized_official_last_name": "BANTA",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "JACK",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "214-987-3434",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "TX",
            "license": "J0438",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CZ0012",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Northeast Texas Home Health Agency, LTD
• Northern Star Ride
• Northlake OB/GYN
• Northpark Counseling Associates, Inc. (New Roads Outpatient Services)
• Northpark Health Partners
• Northpark Surgery Suites, Inc.
• Northpoint Pediatric Care P.a.
• Northpoint Radiation Center GP LLC
• Northpoint Radiation Dallas GP, LLC (Northpoint Cancer Center GP, LLC)
• Northside OB GYN Associates

• Orthopaedic Surgery of the Spine Physician in Dallas, TX
• Providers in Dallas, TX by specialty
• Orthopaedic Surgery of the Spine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2007; 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.