Organization Active NPI

Atlantic Orthopaedics, PA

  • Orthopaedic Surgery Physician
  • Daytona Beach, FL
National Provider Identifier
1487788824
Registry record updated Aug 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
ME0027133 Issued in FL
Legal business name
ATLANTIC ORTHOPAEDICS, PA
Practice address
1020 Mason Ave
Daytona Beach, FL 32117
Phone
(386) 760-0915
Fax
(386) 760-0084
NPI assigned
Mar 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2010

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

Authorized official

Name
Mrs. Shirley K Muck
Title
Practice Manager
Phone
(386) 760-0915

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207X00000X ME0044566 FL
Orthopaedic Surgery PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207X00000X ME0027133 FL Primary

Addresses

Primary practice location

1020 Mason Ave
Daytona Beach, FL 32117

Mailing address

1400 Dunlawton Ave Ste 1-a
Port Orange, FL 32127-8952
Phone (386) 760-0915

Other identifiers 2

IdentifierTypeStateIssuer
ME0027133OtherFLLISCENSE
ME0044566OtherFLLISCENSE

National Provider Directory

National Provider Directory

Locations

1400 Dunlawton Ave
Ste 1A
Port Orange, FL 32127
Phone (386) 760-5008

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281052800000",
    "number": "1487788824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 DUNLAWTON AVE STE 1-A",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321278952",
            "telephone_number": "386-760-0915",
            "fax_number": "386-760-0084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 MASON AVE",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "32117",
            "telephone_number": "386-760-0915",
            "fax_number": "386-760-0084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTIC ORTHOPAEDICS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-16",
        "last_updated": "2010-08-06",
        "status": "A",
        "authorized_official_last_name": "MUCK",
        "authorized_official_first_name": "SHIRLEY",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "386-760-0915",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "FL",
            "license": "ME0044566",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "FL",
            "license": "ME0027133",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LISCENSE",
            "identifier": "ME0027133",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LISCENSE",
            "identifier": "ME0044566",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Daytona Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 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.