NPIMap

Organization Active NPI

South Florida Orthopaedics & Sports Medicine, PA

  • Durable Medical Equipment & Medical Supplies
  • Port Saint Lucie, FL
National Provider Identifier
1700201100
Registry record updated Jan 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
SOUTH FLORIDA ORTHOPAEDICS & SPORTS MEDICINE, PA
Practice address
9401 SW Discovery Way Ste 201
Port Saint Lucie, FL 34987-2381
Phone
(772) 288-2400
NPI assigned
Feb 22, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2019

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

Authorized official

Name
Dr. William E Carlson, MD
Title
Managing Partner
Phone
(772) 288-2400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

9401 SW Discovery Way Ste 201
Port Saint Lucie, FL 34987-2381

Mailing address

1050 SE Monterey Rd
Suite 400
Stuart, FL 34994-4512
Phone (772) 288-2400

Other practice location 1

124 SW Chamber Ct
Port St Lucie, FL 34986-3496
Phone (772) 288-2400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190319002742 FL DME Supplier - Physician - Orthopedic/Orthopedic Surgery 6406838895 Practice locations: Port Saint Lucie, FL

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
South Florida Orthopaedics10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Locations

124 SW Chamber Ct
Port St Lucie, FL 34986

Practitioners & affiliated clinicians

Practitioners 3

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": "1393027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1547510400000",
    "number": "1700201100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 SE MONTEREY RD",
            "address_2": "SUITE 400",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349944512",
            "telephone_number": "772-288-2400",
            "fax_number": "772-419-0143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9401 SW DISCOVERY WAY STE 201",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349872381",
            "telephone_number": "772-288-2400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "124 SW Chamber Ct",
            "address_purpose": "LOCATION",
            "city": "Port St Lucie",
            "state": "FL",
            "postal_code": "349863496",
            "country_code": "US",
            "telephone_number": "772-288-2400",
            "fax_number": "772-419-0143",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SOUTH FLORIDA ORTHOPAEDICS & SPORTS MEDICINE, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-22",
        "last_updated": "2019-01-15",
        "status": "A",
        "authorized_official_last_name": "CARLSON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "772-288-2400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Saint Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2019; 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.