Organization Active NPI

Southland Bone & Joint Institute, PSC

  • Orthopaedic Surgery Physician
  • Munster, IN
National Provider Identifier
1659522357
Registry record updated Feb 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
50004723A Issued in IN
Legal business name
SOUTHLAND BONE & JOINT INSTITUTE, PSC
Practice address
7550 Hohman Ave Ste 400
Munster, IN 46321-1059
Phone
(219) 513-0660
Fax
(219) 513-0670
NPI assigned
Oct 1, 2008
Organization subpart
Yes
Parent organization
SOUTHLAND BONE & JOINT INSTITUTE, S.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 4, 2009

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

Authorized official

Name
Wendi L Jeffers
Title
Office Manager
Phone
(708) 283-2600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207X00000X 50004723A IN Primary

Addresses

Primary practice location

7550 Hohman Ave Ste 400
Munster, IN 46321-1059

Mailing address

PO Box 4097
Aurora, IL 60507-4097
Phone (708) 283-2600

Other identifiers 1

IdentifierTypeStateIssuer
01632336OtherILBLUE SHIELD PROVIDER NUMBER

National Provider Directory

National Provider Directory
Part of
Southland Bone JNT Inst SC

Practitioners & affiliated clinicians

Practitioners 4

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": "1222819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233705600000",
    "number": "1659522357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4097",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605074097",
            "telephone_number": "708-283-2600",
            "fax_number": "708-283-1635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7550 HOHMAN AVE STE 400",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463211059",
            "telephone_number": "219-513-0660",
            "fax_number": "219-513-0670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHLAND BONE & JOINT INSTITUTE, PSC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTHLAND BONE & JOINT INSTITUTE, S.C.",
        "enumeration_date": "2008-10-01",
        "last_updated": "2009-02-04",
        "status": "A",
        "authorized_official_last_name": "JEFFERS",
        "authorized_official_first_name": "WENDI",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "708-283-2600"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "IN",
            "license": "50004723A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD PROVIDER NUMBER",
            "identifier": "01632336",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Munster, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2009; 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.