Jackson Orthopaedic Care & Surgery, P.C.

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

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

Nov 10, 2006

Organization subpart

No

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

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 3

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

• Khawaja Haroun Ikram, D.O.

  • Orthopaedic Surgery Physician
  • Jackson, MI
  • NPI 1881775708

  MI, Orthopaedic Surgery

  Medicare reassignment NPD 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

  Orthopaedic Surgery

  NPD (past)

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

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428019200000",
    "number": "1649341876",
    "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": "NO",
        "enumeration_date": "2006-11-10",
        "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": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "MI",
            "license": "5101010754",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1881775708",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jackson Implants & Periodontics
• Jackson OB-GYN PLC
• Jackson OB/GYN
• Jackson Opco, LLC
• Jackson Orthopaedic Care & Surgery, P.C.
• Jackson Orthopedic Specialist
• Jackson Orthopedics Specialist
• Jackson Pathology Associates, PC
• Jackson Pediatric Dentistry PC
• Jackson Radiology Consultants, P C

• All providers in Jackson, MI
• Orthopaedic Surgery Physician 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.