NPIMap

Organization Active NPI

University Orthopaedic Clinic, PC

  • Orthopaedic Surgery Physician
  • Carrolton, AL
National Provider Identifier
1467755405
Registry record updated Dec 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
UNIVERSITY ORTHOPAEDIC CLINIC, PC
Practice address
241 Robert K Wilson Drive
Carrolton, AL 35447-0478
Phone
(205) 345-0192
Fax
(205) 247-2194
NPI assigned
Dec 14, 2010
Organization subpart
Yes
Parent organization
UNIVERSITY ORTHOPAEDIC CLINIC, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 14, 2010

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

Authorized official

Name
Mrs. Donna S Wood
Title
Chief Executive Officer
Phone
(205) 345-0192

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X Primary
Orthopaedic Surgery of the Spine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207XS0117X
Surgical Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363AS0400X

Addresses

Primary practice location

241 Robert K Wilson Drive
Carrolton, AL 35447-0478

Mailing address

PO Box 2447
Tuscaloosa, AL 35403-2447
Phone (205) 345-0192

Other identifiers 2

IdentifierTypeStateIssuer
51036272OtherALBLUE CROSS BLUE SHIELD
528301220MedicaidAL

National Provider Directory

National Provider Directory
Tax ID family
University Orthopaedic Clinic PC4 organizations share this tax ID, including this one
Part of
University Orthopaedic Clinic PC

Other organizations with this tax ID 3

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1292284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292284800000",
    "number": "1467755405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2447",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354032447",
            "telephone_number": "205-345-0192",
            "fax_number": "205-247-2194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "241 ROBERT K WILSON DRIVE",
            "city": "CARROLTON",
            "state": "AL",
            "postal_code": "354470478",
            "telephone_number": "205-345-0192",
            "fax_number": "205-247-2194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY ORTHOPAEDIC CLINIC, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UNIVERSITY ORTHOPAEDIC CLINIC, PC",
        "enumeration_date": "2010-12-14",
        "last_updated": "2010-12-14",
        "status": "A",
        "authorized_official_last_name": "WOOD",
        "authorized_official_first_name": "DONNA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "205-345-0192",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "51036272",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "528301220",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carrolton, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2010; 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.