Orthopedics of South Central Indiana LLC

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

ORTHOPEDICS OF SOUTH CENTRAL INDIANA LLC

Practice address

583 S Clarizz Blvd
Bloomington, IN 47401-5515

Phone

(812) 333-2663

Fax

(812) 333-8140

NPI assigned

Jun 21, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Michael Craig

Title

Cfo

Phone

(812) 353-9554

Specialties & licenses 9

Addresses

Other identifiers 3

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Indiana University Health Southern Indiana Physicians, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Martinsville, IN
  • NPI 1740608926

  Member Of

  NPD member

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Orthopedics of South Central Indiana, LLC

  • Durable Medical Equipment & Medical Supplies
  • Bloomington, IN
  • NPI 1265850432
  NPPES parent name

Practitioners 3

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

• Tara Jo Rudisill, PA-C

  • Physician Assistant
  • Bloomington, IN
  • NPI 1982971719
  NPD (past)
• Daniel K Lee, DO

  • Orthopaedic Surgery Physician
  • Minot, ND
  • NPI 1679891535

  Specialist

  NPD (past)
• Nicole Marie Perez, PA

  • Physician Assistant
  • New York, NY
  • NPI 1225389745
  NPD (past)

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1518652800000",
    "number": "1588600472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "583 S CLARIZZ BLVD",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474015515",
            "telephone_number": "812-353-6091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "583 S CLARIZZ BLVD",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474015515",
            "telephone_number": "812-333-2663",
            "fax_number": "812-333-8140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOPEDICS OF SOUTH CENTRAL INDIANA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-21",
        "last_updated": "2018-02-15",
        "status": "A",
        "authorized_official_last_name": "CRAIG",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "812-353-9554",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200410200A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CK6083",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "000000256995",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brenton Douglas Ormiston, O.D.
• Diana Ortega Monge, DOT
• Paola Ortega
• Eric H Orth, DO
• Orthopaedics-Indianapolis, Inc.
• Orthopedics of South Central Indiana, LLC
• Desiree Ortiz-Cruz, MD
• Hailey Elizabeth Ortyl, OD
• Brittany Marie Osborn, CNM
• Whitney P. Osborn, NP-C

• Specialist in Bloomington, IN
• Providers in Bloomington, IN by specialty
• Specialist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2018; 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.