Jackson Orthopaedic Care & Surgery, P.C.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

5101010754 Issued in MI

Legal business name

JACKSON ORTHOPAEDIC CARE & SURGERY, P.C.

Practice address

200 Summit Ave
Suite a
Jackson, MI 49201-2464

Phone

(517) 784-1495

Fax

(517) 784-1051

NPI assigned

May 24, 2007

Last updated

Apr 3, 2015By the provider in NPPES

Organization subpart

Yes

Parent organization

JACKSON ORTHOPAEDIC CARE & SURGERY PCAs reported in NPPES

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

Authorized official

Name

Dr. Khawaja Haroun Ikram, D.O.NPI 1881775708

Title

President

Phone

(517) 784-1495

Specialties & licenses 1

Addresses

Other identifiers 1

Part of

Jackson Orthopaedic Care PC

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.

• Khawaja Haroun Ikram, D.O.

  • Orthopaedic Surgery Physician
  • Jackson, MI
  • NPI 1881775708
  NPD (past) Authorized official
• Elizabeth Marie Mikulich, F.N.P.

  • Family Nurse Practitioner
  • Ann Arbor, MI
  • NPI 1740533736
  NPD (past)
• Khawaja Nimr Ikram, D.O.

  • Orthopaedic Surgery Physician
  • Plano, TX
  • NPI 1174604474
  NPD (past)

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428019200000",
    "number": "1609087626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3816 MOMENTUM PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606895338",
            "telephone_number": "517-784-1495",
            "fax_number": "517-784-1051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 SUMMIT AVE",
            "address_2": "SUITE A",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492012464",
            "telephone_number": "517-784-1495",
            "fax_number": "517-784-1051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON ORTHOPAEDIC CARE & SURGERY, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JACKSON ORTHOPAEDIC CARE & SURGERY PC",
        "enumeration_date": "2007-05-24",
        "last_updated": "2015-04-03",
        "status": "A",
        "authorized_official_last_name": "IKRAM",
        "authorized_official_first_name": "KHAWAJA",
        "authorized_official_middle_name": "HAROUN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "517-784-1495",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MI",
            "license": "5101010754",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS SUPPLIER PIN",
            "identifier": "540C811480",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jackson Home Medical Equipment, Inc. (The Aumack Company)
• Jackson Implants & Periodontics
• Jackson OB-GYN PLC
• Jackson OB/GYN
• Jackson Opco, LLC (Regency at Jackson)
• Jackson Orthopaedic Care & Surgery, P.C.
• Jackson Orthopedic Specialist
• Jackson Orthopedics Specialist
• Jackson Pathology Associates, PC
• Jackson Pediatric Dentistry PC

• Durable Medical Equipment & Medical Supplies in Jackson, MI
• Providers in Jackson, MI by specialty
• Durable Medical Equipment & Medical Supplies in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2015; 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.