The Center for Orthopedic Medicine, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

7002116 Issued in IL

Legal business name

THE CENTER FOR ORTHOPEDIC MEDICINE, LLC

Doing business as

The Center for Outpatient Medicine

Practice address

2502 B. East Empire Street
Bloomington, IL 61704

Phone

(309) 662-6120

Fax

(309) 661-0060

NPI assigned

Jul 4, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Sarah Ellen Gardner

Title

Business Director

Phone

(309) 662-6120

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• The Center for Outpatient Medicine Doing business as

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Listed as

The Center for Orthopedic Medicine LLCCCN 14C0001053

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Member of 1

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

• Carle Clinic Assocation, P.C.

  • Internal Medicine Physician
  • Urbana, IL
  • NPI 1255380846

  Member Of

  NPD member

Practitioners 2

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

• Joseph A Novotny, M.D.

  • Orthopaedic Surgery Physician
  • Bloomington, IL
  • NPI 1881601144
  NPD (past)
• Gary L Knepp, DO

  • Geriatric Medicine (Family Medicine) Physician
  • Lewisburg, WV
  • NPI 1275576514
  NPD (past)

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599782400000",
    "number": "1679503692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2502 B. EAST EMPIRE STREET",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "61704",
            "telephone_number": "309-662-6120",
            "fax_number": "309-661-0060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2502 B. EAST EMPIRE STREET",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "61704",
            "telephone_number": "309-662-6120",
            "fax_number": "309-661-0060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE CENTER FOR ORTHOPEDIC MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-04",
        "last_updated": "2020-09-11",
        "certification_date": "2020-09-11",
        "status": "A",
        "authorized_official_last_name": "GARDNER",
        "authorized_official_first_name": "SARAH",
        "authorized_official_middle_name": "ELLEN",
        "authorized_official_title_or_position": "BUSINESS DIRECTOR",
        "authorized_official_telephone_number": "309-662-6120",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "IL",
            "license": "7002116",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE",
            "identifier": "001937",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "00214363001",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHEILD",
            "identifier": "551",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "490003202",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Center for Outpatient Medicine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Center for Outpatient Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Laura Tepen, LPC
• Debra Diann Terfruchte, LCSW
• Morgan Teston, FNP-C
• Andrew Tharp, NURSE PRACTITIONER
• The Carle Foundation Hospital (Carle Medical Supply)
• The Center for Youth and Family Solutions
• The Center for Youth and Family Solutions
• The Healing Tree Psychotherapy and Consulting Services, LLC
• The Therapy Collaborative
• The Vein Specialists, LLC

• Ambulatory Surgical Clinic/Center in Bloomington, IL
• Providers in Bloomington, IL by specialty
• Ambulatory Surgical Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.