Ada Orthopedics & Sports Medicine, PC

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

Legal business name

ADA ORTHOPEDICS & SPORTS MEDICINE, PC

Practice address

625 N Monte Vista St
Ada, OK 74820-4613

Phone

(580) 332-4443

Fax

(580) 332-4846

NPI assigned

Feb 1, 2007

Last updated

Mar 27, 2008By 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

Roger John Charboneau, D.O.

Title

Surgeon

Phone

(580) 332-4443

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206576000000",
    "number": "1427196773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 N MONTE VISTA ST",
            "city": "ADA",
            "state": "OK",
            "postal_code": "748204613",
            "telephone_number": "580-332-4443",
            "fax_number": "580-332-4846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 N MONTE VISTA ST",
            "city": "ADA",
            "state": "OK",
            "postal_code": "748204613",
            "telephone_number": "580-332-4443",
            "fax_number": "580-332-4846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADA ORTHOPEDICS & SPORTS MEDICINE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-01",
        "last_updated": "2008-03-27",
        "status": "A",
        "authorized_official_last_name": "CHARBONEAU",
        "authorized_official_first_name": "ROGER",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "SURGEON",
        "authorized_official_telephone_number": "580-332-4443",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DD1743",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ada Health First Inc
• Ada Medical Group PLLC
• Ada Medical Inc (Ada Physical Therapy)
• Ada Men's Clinic LLC (Ada Family Wellness Clinic)
• Ada MRI Associates, L.L.C. (Ada Open MRI)
• Ada Outpatient Clinic, Inc.
• Ada Pediatric Clinic
• Ada Residential Care Inc.
• Ada Senior Care Center
• Ada Smile Place, PLLC

• Orthopaedic Surgery Physician in Ada, OK
• Providers in Ada, OK by specialty
• Orthopaedic Surgery Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2008; 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.