NPIMap

Organization Active NPI

Regional Orthopaedics & Sports Medicine Center, LTD.

  • Orthopaedic Surgery Physician
  • Jacksonville, IL
National Provider Identifier
1609990944
Registry record updated Jul 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
036088511 Issued in IL
Legal business name
REGIONAL ORTHOPAEDICS & SPORTS MEDICINE CENTER, LTD.
Practice address
1600 W Walnut St
Jacksonville, IL 62650-1136
Phone
(217) 243-0033
Fax
(217) 245-1791
NPI assigned
Mar 19, 2007
Last updated
Jul 10, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2008

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

Authorized official

Name
Darr W Leutz, M.D.
Title
President
Phone
(217) 243-0033

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 036088511 IL Primary

Addresses

Primary practice location

1600 W Walnut St
Jacksonville, IL 62650-1136

Mailing address

1600 W Walnut St
Jacksonville, IL 62650-1136
Phone (217) 243-0033

Other identifiers 1

IdentifierTypeStateIssuer
036088511MedicaidIL

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215648000000",
    "number": "1609990944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 W WALNUT ST",
            "city": "JACKSONVILLE",
            "state": "IL",
            "postal_code": "626501136",
            "telephone_number": "217-243-0033",
            "fax_number": "217-245-1791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 W WALNUT ST",
            "city": "JACKSONVILLE",
            "state": "IL",
            "postal_code": "626501136",
            "telephone_number": "217-243-0033",
            "fax_number": "217-245-1791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGIONAL ORTHOPAEDICS & SPORTS MEDICINE CENTER, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-19",
        "last_updated": "2008-07-10",
        "status": "A",
        "authorized_official_last_name": "LEUTZ",
        "authorized_official_first_name": "DARR",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "217-243-0033",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "IL",
            "license": "036088511",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036088511",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2008; 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.