Orthonc ASC, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

ORTHONC ASC, LLC

Practice address

11221 Galleria Ave Ste 105
Raleigh, NC 27614-8137

Phone

(919) 562-9410

NPI assigned

Jun 21, 2021

Last updated

Jun 1, 2022By 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

Mrs. Lisa Johnson

Title

Director of Clinical Operations

Phone

(919) 562-9410

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Listed as

Ortho NC ASC LLCCCN 34C0001222

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 3

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.

• Mark William Galland, MD

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Raleigh, NC
  • NPI 1689741894
  NPD
• Clifford Roberts Wheeless III, MD

  • Orthopaedic Surgery Physician
  • Raleigh, NC
  • NPI 1205903408
  NPD
• Dominique Lillian McCray Williams, LAT, ATC, EMT

  • Athletic Trainer
  • Raleigh, NC
  • NPI 1245721968
  NPD (past)

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

{
    "created_epoch": "1624233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654041600000",
    "number": "1487223814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1107",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275881107",
            "telephone_number": "919-562-9410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11221 GALLERIA AVE STE 105",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276148137",
            "telephone_number": "919-562-9410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHONC ASC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-21",
        "last_updated": "2022-06-01",
        "certification_date": "2022-06-01",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "DIRECTOR OF CLINICAL OPERATIONS",
        "authorized_official_telephone_number": "919-562-9410",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Debra Sigmon Orr, AGNP
• Amy Ort, LMFT
• Kirenia Ortega Roja
• Glenn P Ortenzio
• Ortho Sport & Spine Physicians Raleigh
• Orthopaedic and Sports Medicine Associates, PLLC
• Orthopaedic Specialists of North Carolina, P.a. (OrthoNC)
• Orthopaedic Specialists of North Carolina, P.a. (OrthoNC)
• Orthopaedic Specialists of North Carolina, P.a. (OrthoNC)
• Orthopaedic Specialists of North Carolina, P.a. (OrthoNC)

• Ambulatory Surgical Clinic/Center in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Ambulatory Surgical Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.