NPIMap

Organization Active NPI

Southeastern Orthopaedic Specialists

Doing business as Sports Medicine and Orthopaedic Center

  • Orthopaedic Surgery Physician
  • High Point, NC
National Provider Identifier
1437338571
Registry record updated Oct 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
SOUTHEASTERN ORTHOPAEDIC SPECIALISTS
Doing business as
Sports Medicine and Orthopaedic Center
Practice address
209 Lindsay St
Suite 204
High Point, NC 27262-4853
Phone
(336) 887-8400
Fax
(336) 887-3013
NPI assigned
Oct 25, 2007
Last updated
Oct 25, 2007By the provider in NPPES
Organization subpart
Yes
Parent organization
SOUTHEASTERN ORTHOPAEDIC SPECIALISTSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 25, 2007

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

Authorized official

Name
Dr. Rodney A. Mortenson, M.D.NPI 1184677734
Title
Senior Partner
Phone
(336) 275-6318

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 PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X Primary

Addresses

Primary practice location

209 Lindsay St
Suite 204
High Point, NC 27262-4853

Mailing address

209 Lindsay St
Suite 204
High Point, NC 27262-4853
Phone (336) 887-8400

Other identifiers 1

IdentifierTypeStateIssuer
1190220002OtherNCDME LOCATION PROVIDER NUM

Other names 1

  • Sports Medicine and Orthopaedic Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Southeastern Orthopaedic Specialists4 organizations share this tax ID, including this one
Part of
Southeastern Orthopaedic Specialists

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

209 Lindsay St
High Point, NC 27262
Phone (336) 887-8400

209 Lindsay St
Ste 204
High Point, NC 27262
Phone (336) 887-8400

Practitioners & affiliated clinicians

Practitioners 6

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": "1193270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193270400000",
    "number": "1437338571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 LINDSAY ST",
            "address_2": "SUITE 204",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272624853",
            "telephone_number": "336-887-8400",
            "fax_number": "336-887-3013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 LINDSAY ST",
            "address_2": "SUITE 204",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272624853",
            "telephone_number": "336-887-8400",
            "fax_number": "336-887-3013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEASTERN ORTHOPAEDIC SPECIALISTS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTHEASTERN ORTHOPAEDIC SPECIALISTS",
        "enumeration_date": "2007-10-25",
        "last_updated": "2007-10-25",
        "status": "A",
        "authorized_official_last_name": "MORTENSON",
        "authorized_official_first_name": "RODNEY",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "SENIOR PARTNER",
        "authorized_official_telephone_number": "336-275-6318",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DME LOCATION PROVIDER NUM",
            "identifier": "1190220002",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sports Medicine and Orthopaedic Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in High Point, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2007; 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.